[Federal Register Volume 74, Number 242 (Friday, December 18, 2009)]
[Notices]
[Page 67255]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-30168]


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OFFICE OF PERSONNEL MANAGEMENT

[OMB Control No. 3206-0172; Standard Form 3104 and Standard Form 3104B]


Proposed Collection; Request for Comments Review of a Revised 
Information Collection

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) intends to submit to the Office of 
Management and Budget (OMB) a request for review of a revised 
information collection. ``Application for Death Benefits--FERS'' (OMB 
Control No. 3206-0172; Standard Form 3104), is used by persons applying 
for death benefits which may be payable under FERS because of the death 
of an employee, former employee, or retiree who was covered by FERS at 
the time of his/her death or separation from Federal Service. 
``Documentation and Elections in Support of Application for Death 
Benefits when Deceased was an Employee at the Time of Death--FERS'' 
(OMB Control No. 3206-0172; Standard Form 3104B), is used by applicants 
for death benefits under FERS if the deceased was a Federal employee at 
the time of death.
    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 
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.
    We estimate that approximately 9,607 SF 3104s will be processed 
annually and each form takes approximately 60 minutes to complete. An 
annual burden of 9,607 hours is estimated. We estimate that 
approximately 3,759 SF 3104Bs will be processed annually and each form 
takes approximately 60 minutes to complete. An annual burden of 3,759 
hours is estimated. The total annual estimated burden is 13,366.
    For copies of this proposal, contact Cyrus S. Benson on (202) 606-
4808, FAX (202) 606-0910 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--James K. Freiert, 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 20415-3500.
    For information regarding administrative Coordination contact: 
Cyrus S. Benson, Team Leader, Publications Team, RIS Support Services/
Support Group, U.S. Office of Personnel Management, 1900 E Street, NW., 
Room 4H28, Washington, DC 20415, (202) 606-0623.
U.S. Office of Personnel Management.

John Berry,
Director.
[FR Doc. E9-30168 Filed 12-17-09; 8:45 am]
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