[Federal Register Volume 61, Number 26 (Wednesday, February 7, 1996)]
[Notices]
[Pages 4689-4690]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-2544]



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OFFICE OF PERSONNEL MANAGEMENT

[RI 78-11]


Notice of Intention To Request Review of an Expiring Information 
Collection

AGENCY: Office of Personnel Management.

ACTION: Notice.

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SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Pub. 
L. 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management intends to submit to the Office of Management and 
Budget a request for a clearance of an expiring information collection. 
RI 78-11, Medicare Part B Certification, is used to determine 
eligibility for a Government contribution toward the cost of Medicare 
Part B if enrolled in the Retired Federal Employees Health Benefits 
Program.
    We estimate 300 RI 78-11 forms are completed annually. Each form 
takes approximately 10 minutes to complete for an annual estimated 
burden of 50 hours.
    For copies of this proposal, contact Jim Farron on (202) 418-3208, 
or E-Mail to jmfarronmail.opm.gov

DATES: Comments on this proposal should be received on or before April 
8, 1996.

ADDRESSES: Send or deliver comments to: Lorraine E. Dettman, Chief, 
Operations Support Division, Retirement and Insurance Service, 1900 E 
Street, NW., Room 3349, Washington, DC 20415-0001.

FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION--CONTACT:

[[Page 4690]]

Mary Beth Smith-Toomey, Team Leader Management Services Division (202) 
606-0623.

U.S. Office of Personnel Management.
Lorraine A. Green,
Deputy Director.
[FR Doc. 96-2544 Filed 2-6-96; 8:45 am]
BILLING CODE 6325-01-M