[Federal Register Volume 70, Number 69 (Tuesday, April 12, 2005)]
[Notices]
[Page 19132]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-7276]


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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: Supplemental 
Information on Accident and Insurance.
    (2) Form(s) submitted: SI-1c, SI-5, ID-3s, ID-3s-1, ID-3u, ID-30-k, 
ID-30k-1.
    (3) OMB Number: 3220-0036.
    (4) Expiration date of current OMB clearance: 05/31/2005.
    (5) Type of request: Extension of a currently approved collection.
    (6) Respondents: Individuals or households, Business or other for-
profit.
    (7) Estimated annual number of respondents: 10,000.
    (8) Total annual responses: 28,500.
    (9) Total annual reporting hours: 1,691.
    (10) Collection description: The Railroad Unemployment Insurance 
Act provides for the recovery of sickness benefits paid if an employee 
receives a settlement for the same injury for which benefits were paid. 
The collection obtains information about the person or company 
responsible for such payments that is needed to determine the amount of 
the RRB's entitlement.
    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. 05-7276 Filed 4-11-05; 8:45 am]
BILLING CODE 7905-01-P