[Federal Register Volume 69, Number 22 (Tuesday, February 3, 2004)]
[Notices]
[Pages 5216-5217]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-2081]


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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: Railroad Unemployment Insurance Act 
Applications.
    (2) Form(s) submitted: SI-1a, SI-1b, SI-3, SI-7, SI-8, ID-7H, ID-
11A, ID-11-B.
    (3) OMB Number: 3220-0039.
    (4) Expiration date of current OMB clearance: 5/31/2004.
    (5) Type of request: Revision of a currently approved collection.
    (6) Respondents: Individuals or households, Business or other for-
profit.
    (7) Estimated annual number of respondents: 44,600.
    (8) Total annual responses: 260,900.
    (9) Total annual reporting hours: 26,321.
    (10) Collection description: Under section 2 of the Railroad 
Unemployment Insurance Act, sickness benefits are payable to qualified 
railroad employees who are unable to work because of

[[Page 5217]]

illness or injury. The collection obtains information from railroad 
employees and physicians needed to determine eligibility to and the 
amount of such benefits.
    Additional Information or Comments: Copies of the forms and 
supporting documents can be obtained from Charles Mierzwa, the agency 
clearance officer at (312) 751-3363 or [email protected].
    Comments regarding the information collection should be addressed 
to Ronald J. Hodapp, Railroad Retirement Board, 844 North Rush Street, 
Chicago, Illinois, 60611-2092 or [email protected] and to the OMB 
Desk Officer for the RRB, at the Office of Management and Budget, Room 
10230, New Executive Office Building, Washington, DC 20503.

Charles Mierzwa,
Clearance Officer.
[FR Doc. 04-2081 Filed 2-2-04; 8:45 am]
BILLING CODE 7905-01-P