[Federal Register Volume 69, Number 233 (Monday, December 6, 2004)]
[Notices]
[Page 70480]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-26729]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for OMB Review; 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) has submitted 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, Temporary Continuation of Coverage enrollees, and 
direct pay annuitants to change health benefits enrollment or request 
plan brochures for plans they wish to consider for enrollment during 
open season.
    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 30 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to--
Ellen Korchek, CEBS, Chief, Program Planning & Evaluation Group, 
Insurances Services Program, Center for Retirement and Insurance 
Services, U.S. Office of Personnel Management, 1900 E Street, NW., Room 
3425, Washington, DC 20415-3650
     and
Joseph F. Lackey, OPM Desk Officer, Office of Information and 
Regulatory Affairs, Office of Management & Budget, New Executive Office 
Building, NW., Room 10235, Washington, DC 20503.

    For Information Regarding Administrative Coordination--Contact: 
Cyrus S. Benson, Team Leader, Publications Team, Support Group, (202) 
606-0623.

Office of Personnel Management.
Kay Coles James,
Director.
[FR Doc. 04-26729 Filed 12-3-04; 8:45 am]
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