[Federal Register Volume 69, Number 42 (Wednesday, March 3, 2004)]
[Notices]
[Page 10076]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-4736]


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OFFICE OF PERSONNEL MANAGEMENT


Proposed Collection; Comment Request for Review of an Expiring 
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 intends to submit to the Office of Management and 
Budget a request for an expiring 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 former dependents include certain 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 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 will be 4,500 hours.
    Comments are particularly invited on: Whether this information is 
necessary for the proper performance of functions of the Office of 
Personnel Management, and whether it will have practical utility; 
whether our estimate of the public burden of this collection of 
information is accurate, and based on valid assumptions and 
methodology; and ways in which we can minimize the burden of the 
collection of information on those who are to respond, through the use 
of appropriate technological collection techniques or other forms of 
information technology.
    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 60 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to: Frank D. Titus, Assistant 
Director, Insurance Services Program, Center for Retirement & Insurance 
Services, U.S. Office of Personnel Management, 1900 E Street, NW., Room 
3400, Washington, DC 20415.
    For Information Regarding Administrative Coordination Contact: 
Cyrus S. Benson, Team Leader, Publications Team, Administrative 
Services Branch, (202) 606-0623.

U.S. Office of Personnel Management.
Kay Coles James,
Director.
[FR Doc. 04-4736 Filed 3-2-04; 8:45 am]
BILLING CODE 6325-38-P