[Federal Register Volume 69, Number 167 (Monday, August 30, 2004)]
[Notices]
[Pages 52941-52942]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-19635]


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OFFICE OF PERSONNEL MANAGEMENT


Proposed Collection; Comment Request for Review of a Revised 
Information Collection: RI 78-11

AGENCY: Office of Personnel Management.

ACTION: Notice.

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SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Public 
Law 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management (OPM) intends to submit to the Office of 
Management and Budget a request for review of a revised information 
collection. RI 78-11, Medicare Part B Certification, collects 
information from annuitants, their spouses, and survivor annuitants to 
determine their eligibility under the Retired Federal Employees Health 
Benefits Program for a Government contribution toward the cost of Part 
B of Medicare.
    Comments are particularly invited on: whether this collection of 
information is necessary for the proper performance of functions of 
OPM, and whether it will have practical utility; whether our estimate 
of the public burden of this collection 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 use of the appropriate technological collection techniques or 
other forms of information technology.
    Approximately 100 RI 78-11 forms are completed annually. Each form 
requires approximately 10 minutes to complete. The annual estimated 
burden is 17 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.

[[Page 52942]]


DATES: Comments on this proposal should be received within 60 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to: Ronald W. Melton, Deputy 
Assistant Director, Retirement Services Program, Center for Retirement 
and Insurance Services, U.S. Office of Personnel Management, 1900 E 
Street, NW., Room 3305, Washington, DC 20415-3540.

FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION CONTACT: Cyrus S. 
Benson, Team Leader, Publications Team, RIS Support Services/Support 
Group, (202) 606-0623.

    U.S. Office of Personnel Management.
Kay Coles James,
Director.
[FR Doc. 04-19635 Filed 8-27-04; 8:45 am]
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