[Federal Register Volume 67, Number 130 (Monday, July 8, 2002)]
[Notices]
[Pages 45159-45160]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-16950]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for OMB Review; Comment Request for Reclearance of an 
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 and 5 CFR 1320), this notice announces that 
the Office of Personnel Management (OPM) has submitted to the Office of 
Management and Budget (OMB) a request for reclearance of an information 
collection. SF 2809, Employee Health Benefits Election Form, is used by 
Federal employees to enroll for health insurance coverage under the 
Federal Employees Health Benefits (FEHB) Program. Certain former 
spouses of Federal employees, who are eligible for enrollment under the 
Spouse Equity Act of 1984 (P.L. 98-615), and former employees and 
former dependents who are eligible for enrollment under the Temporary 
Continuation of Coverage (TCC) provisions of FEHB law (5 U.S.C. 8905a) 
also use this form.
    Approximately 9,000 SF 2809 forms are completed annually. Each form 
takes

[[Page 45160]]

approximately 30 minutes to complete. The annual estimated burden is 
4,500 hours.
    For copies of this proposal, contact Mary Beth Smith-Toomey on 
(202) 606-8358, FAX (202) 418-3251 or e-mail to [email protected]. 
Please be sure to include a mailing address with your request.

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

ADDRESSES: Send or deliver comments to--

Abby L. Block, Assistant Director, Office of Insurance Programs, 
Retirement and Insurance Service, U.S. Office of Personnel Management, 
1900 E Street, NW, Room 3400, Washington, DC 20415-3600, and
Joseph Lackey, OPM Desk Officer, Office of Information & Regulatory 
Affairs, Office of Management and Budget, New Executive Office 
Building, NW, Room 10235, Washington, DC 20503.

FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION CONTACT: Cyrus S. 
Benson, Team Leader, Budget and Administrative Services Division, 
Desktop Publishing and Printing Team, (202) 606-0623.

Office of Personnel Management.
Kay Coles James,
Director.
[FR Doc. 02-16950 Filed 7-5-02; 8:45 am]
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