[Federal Register Volume 59, Number 123 (Tuesday, June 28, 1994)]
[Unknown Section]
[Page ]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-15480]


[Federal Register: June 28, 1994]


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OFFICE OF PERSONNEL MANAGEMENT


Notice of Request for Reclearance of SF 3104, SF 3104A, and SF 
3104B

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 a 
reclearance of an information collection. SF 3104, Application for 
Death Benefits (FERS), is needed for the Office of Personnel Management 
to determine whether death benefits should be paid, to whom, and in 
what amount. SF 3104A (attached to SF 3104), requests information from 
the survivor which is used by OPM to determine entitlement to a 
survivor annuity supplement (supplementary annuity). SF 3104B is used 
by the deceased employee's former employing agency in death-in-service 
cases, to supply the survivor's application for death benefits (SF 
3104).
    Approximately 3,546 SF 3104s are completed annually. We estimate 
that it takes 60 minutes to fill out the form. The annual burden is 
3,546 hours. Approximately 2,766 SF 3104Bs are completed annually. We 
estimate that it takes 60 minutes to fill out the form. The annual 
burden is 2,766 hours. The combined total annual burden is 6,312 hours.
    For copies of this proposal, contact C. Ronald Trueworthy on (703) 
908-8550.

DATES: Comments on this proposal should be received within 30 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to--

Daniel A. Green, Retirement and Insurance Group, FERS Division, U.S. 
Office of Personnel Management, 1900 E. Street, NW, Room 4429, 
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 FURTHER REGARDING ADMINISTRATIVE COORDINATION--CONTACT:
Mary Beth Smith-Toomey, Chief, Forms Analysis and Design, (202) 606-
0623.

U.S. Office of Personnel Management
Lorraine A. Green,
Deputy Director.
[FR Doc. 94-15480 Filed 6-27-94; 8:45 am]
BILLING CODE 6325-01-M