[Federal Register Volume 61, Number 214 (Monday, November 4, 1996)]
[Notices]
[Page 56724]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-28219]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for OMB Review; Comment Request for Revision of 
Information Collection; SF 2809

AGENCY: Office of Personnel Management.

ACTION: Notice.

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SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Public 
Law 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management will submit to the Office of Management and Budget 
a request for reclearance of the following information collection. SF 
2809, Health Benefits Registration Form, is used by annuitants under 
Federal retirement systems other than the Civil Service Retirement 
System and the Federal Employees Retirement System and by the former 
spouses of Federal employees and annuitants to register for and change 
enrollment in the Federal Employees Health Benefits Program. SF 2809 is 
needed to verify entitlement and to effect premium withholdings.
    Approximately 9,000 SF 2809 forms will be processed each year from 
former spouses and annuitants from other retirement systems. Each form 
takes approximately 30 minutes to complete. The annual estimated burden 
is 4,500 hours.
    For copies of this proposal, contact Jim Farron on (202) 418-3208, 
or E-mail to [email protected]

DATES: Comments on this proposal should be received on or before 
December 4, 1996.

ADDRESSES: Send or deliver comments to--

Kenneth H. Glass, Chief, Insurance Operations Division, Retirement and 
Insurance Service, U.S. Office of Personnel Management, 1900 E Street, 
NW, Room 3415, Washington, DC 20415-0001

       and

Joseph Lackey, OPM Desk Office, 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, Management Services Division, (202) 606-0623.

U.S. Office of Personnel Management.
Lorraine A. Green,
Deputy Director.
[FR Doc. 96-28219 Filed 11-1-96; 8:45 am]
BILLING CODE 6325-01-M