[Federal Register Volume 69, Number 34 (Friday, February 20, 2004)]
[Notices]
[Page 7988]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-3663]


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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: Application for Survivor Insurance Annuities.
    (2) Form(s) submitted: AA-17, AA-17b, AA-17cert, AA-18, AA-19, AA-
19a, AA-20.
    (3) OMB Number: 3220-0030.
    (4) Expiration date of current OMB clearance: 6/30/2004.
    (5) Type of request: Extension of a currently approved collection.
    (6) Respondents: Individuals or households.
    (7) Estimated annual number of respondents: 4,137.
    (8) Total annual responses: 4,137.
    (9) Total annual reporting hours: 1,718.
    (10) Collection description: Under Section 2(d) of the Railroad 
Retirement Act, monthly survivor annuities are payable to surviving 
widow(er)s, parents, unmarried children, and in certain cases, divorced 
wives (husband), mothers (fathers), remarried widow(er)s and 
grandchildren of deceased railroad employees. The collection obtains 
information needed by the RRB for determining entitlement to and amount 
of the annuity applied for.
    Additional Information or Comments: Copies of the forms and 
supporting documents can be obtained from Charles Mierzwa, the agency 
clearance officer, (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. 04-3663 Filed 2-19-04; 8:45 am]
BILLING CODE 7905-01-P