[Federal Register Volume 59, Number 114 (Wednesday, June 15, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-14389]


[[Page Unknown]]

[Federal Register: June 15, 1994]


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OFFICE OF PERSONNEL MANAGEMENT
 

Request for Clearance of a Revised Information Collection Form RI 
30-10

AGENCY: Office of Personnel Management.

ACTION: Notice.

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SUMMARY: In accordance with the Paperwork Reduction Act of 1980 (title 
44, U.S. Code, chapter 35), this notice announces a request for 
clearance of a revised information collection. Form RI 30-10, Disabled 
Dependent Questionnaire, is used to collect sufficient information 
about the medical condition and earning capacity for OPM to be able to 
determine whether a disabled adult child is eligible for health 
benefits coverage and/or survivor annuity payments under the Civil 
Service Retirement System/Federal Employees Retirement System.
    Approximately 2,500 RI 30-10 forms are completed annually. The form 
requires approximately 30 minutes to complete. The annual burden is 
1,250 hours.
    For copies of this proposal, contact C. Ronald Trueworthy on (703) 
908-8550.

DATES: Comments on this proposal should be received on or before July 
15, 1994.

ADDRESSES: Send or deliver comments to--
Lorraine E. Dettman, Chief, Retirement and Insurance Group, Operations 
Support Division, U.S. Office of Personnel Management, 1900 E Street, 
NW., room 3349, Washington, DC 20415
and
Joseph Lackey, OPM Desk Officer, Office of Information and Regulatory 
Affairs, Office of Management and Budget, New Executive Office 
Building, NW., room 3002, Washington, DC 20503.

FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION--CONTACT:
Mary Beth Smith-Toomey, Chief, Forms Analysis & Design, (202) 606-0623.

U.S. Office of Personnel Management.
Lorraine A. Green,
Deputy Director.
[FR Doc. 94-14389 Filed 6-14-94; 8:45 am]
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