[Federal Register Volume 67, Number 130 (Monday, July 8, 2002)]
[Notices]
[Page 45160]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-16952]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for OMB Review; Comment Request for Reclearance of an 
Information Collection: SF 2809-1

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 (OPM) has submitted to the Office of Management 
and Budget (OMB) a request for reclearance of an information 
collection. SF 2809-1, Annuitant/OWCP Health Benefits Election Form, is 
used by annuitants of Federal retirement systems other than the Civil 
Service Retirement System (CSRS) and the Federal Employees Retirement 
System (FERS), including the Foreign Service Retirement System and the 
Office of Workers' Compensation Programs (OWCP) and certain former 
dependents of these individuals. These include former spouses who are 
eligible for enrollment under the Spouse Equity Act of 1984 (Pub. L. 
98-615) and certain former dependents who are eligible for enrollment 
under the Temporary Continuation of Coverage (TCC) provisions of 
Federal Employees Health Benefits (FEHB) law (5 U.S.C. 8905a).
    Approximately 9,000 SF 2809-1 forms are completed annually. Each 
form takes 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. 02-16952 Filed 7-5-02; 8:45 am]
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