[Federal Register Volume 75, Number 118 (Monday, June 21, 2010)]
[Notices]
[Pages 35091-35092]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-14839]


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OFFICE OF PERSONNEL MANAGEMENT

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


Submission for OMB Review; Comment Request for 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) has submitted 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

[[Page 35092]]

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.
    We estimate that approximately 12,734 SF 3104s will be processed 
annually and each form takes approximately 60 minutes to complete. An 
annual burden of 12,734 hours is estimated. We estimate that 
approximately 4,017 SF 3104Bs will be processed annually and each form 
takes approximately 60 minutes to complete. An annual burden of 4,017 
hours is estimated. The total annual estimated burden is 16,751.
    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 30 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to--

James K. Freiert, Acting, Deputy Associate Director, Retirement 
Operations, Retirement and Benefits, U.S. Office of Personnel 
Management, 1900 E Street, NW., Room 3305, Washington, DC 20415-3500, 
and
OMB Desk Officer, Office of Information & Regulatory Affairs, Office of 
Management and Budget, New Executive Office Building, 725 17th Street, 
NW., Room 10235, Washington, DC 20503.

For information regarding administrative coordination contact: Cyrus S. 
Benson, Team Leader, Publications Team, RB/RM/Administrative Services, 
U.S. Office of Personnel Management, 1900 E Street, NW., Room 4H28, 
Washington DC 20415. (202) 606-4808.

John Berry,
Director, U.S. Office of Personnel Management.
[FR Doc. 2010-14839 Filed 6-18-10; 8:45 am]
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