[Federal Register Volume 61, Number 150 (Friday, August 2, 1996)]
[Notices]
[Pages 40469-40470]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-19619]


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RAILROAD RETIREMENT BOARD


Agency Forms Submitted for OMB Review

SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (44 
U.S.C. Chapter 35), the Railroad Retirement Board has submitted the 
following proposal(s) for the collection of information to the Office 
of Management and Budget for review and approval.

Summary of Proposal(s)

    (1) Colllection title: Medical Reports.
    (2) Form(s) submitted: G-3EMP,
G-250, G-250a, G-260, GL-12, RL-11b, and RL-11d.
    (3) OMB Number: 3220-0038.
    (4) Expiration date of current OMB clearance: August 31, 1996.
    (5) Type of request: Extension of a currently approved collection.
    (6) Respondents: Business or other for-profit, non-profit 
institutions, and State, Local or Tribal Government.
    (7) Estiamted annual number of respondents: 60,950.
    (8) Total annual responses: 60,950.
    (9) Total annual reporting hours: 25,187.
    (10) Collection description: The Railroad Retirement Act provides 
disability annuities for qualified railroad employees whose physical or 
mental condition renders them incapable of working in their regular 
occupation (occupational disability) or any occupation (total 
disability). The medical reports obtain information

[[Page 40470]]

needed for determining the nature and severity of the impairment.

ADDITIONAL INFORMATION OR COMMENTS: Copies of the form and supporting 
documents can be obtained from Chuck Mierzwa, the agency clearance 
officer (312-751-3363). Comments regarding the information collection 
should be addressed to Ronald J. Hodapp, Railroad Retirement Board, 844 
North Rush Street, Chicago, Illinois 60611-2092 and the OMB reviewer, 
Laura Oliven (202-395-7316), Office of Management and Budget, Room 
10230, New Executive Office Building, Washington, D.C. 20503.
Chuck Mierzwa,
Clearance Officer.
[FR Doc. 96-19619 Filed 8-1-96; 8:45 am]
BILLING CODE 7905-01-M