[Federal Register Volume 69, Number 120 (Wednesday, June 23, 2004)]
[Notices]
[Page 35071]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-14098]


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OFFICE OF PERSONNEL MANAGEMENT


Proposed Collection; Comment Request for Review of a Revised 
Information Collection: Form DPRS-2809

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) will submit to the Office of Management and 
Budget (OMB) a request for review of a revised information collection. 
DPRS-2809, Request to Change Federal Employees Health Benefits (FEHB) 
Enrollment or to Receive Plan Brochures, is used by former spouses and 
Temporary Continuation of Coverage recipients who are eligible to 
elect, cancel, or change health benefits enrollment during open season.
    Comments are particularly invited on: Whether this collection of 
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.
    Approximately 27,000 DPRS-2809 forms are completed annually. We 
estimate it takes approximately 45 minutes to complete the form. The 
annual burden is 20,250 hours.
    For copies of this proposal, contact Mary Beth Smith-Toomey on 
(202) 606-8358, FAX (202) 418-3251 or via e-mail to [email protected]. 
Please 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--Ellen Korchek, CEBS, Chief, 
Program Planning & Evaluation Group, Insurance Services Program, Center 
for Retirement & Insurance Services, U.S. Office of Personnel 
Management, 1900 E Street, NW., Room 3425, Washington, DC 20415-3650.
    For Information Regarding Administrative Coordination--Contact: 
Cyrus S. Benson, Team Leader, Publications Team, Support Group, (202) 
606-0623.

U.S. Office of Personnel Management.
Kay Coles James,
Director.
[FR Doc. 04-14098 Filed 6-22-04; 8:45 am]
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