[Federal Register Volume 62, Number 187 (Friday, September 26, 1997)]
[Notices]
[Page 50643]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-25661]


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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 (RRB) 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) Collection title: Evidence of coverage Under An Employer Group 
Health Plan.
    (2) Form(s) submitted: RL-311-F.
    (3) OMB Number: 3220-0189.
    (4) Expiration date of current OMB clearance: November 30, 1997.
    (5) Type of request: Revision of a currently approved collection.
    (6) Respondents: Business or other for profit.
    (7) Estimated annual number of respondents: 1,000.
    (8) Total annual responses: 1,000.
    (9) Total annual reporting hours: 167.
    (10) Collection description: The collection obtains information 
from railroad employers which is needed to determine if a railroad 
retirement beneficiary is entitled to a special enrollment period when 
applying for supplemental medical insurance under Medicare.

ADDITIONAL INFORMATION OR COMMENTS: Copies of the forms 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. 97-25661 Filed 9-25-97; 8:45 am]
BILLING CODE 7905-01-M