[Federal Register Volume 76, Number 134 (Wednesday, July 13, 2011)]
[Notices]
[Pages 41313-41314]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-17644]


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RAILROAD RETIREMENT BOARD


Agency Forms Submitted for OMB Review, Request for Comments

    Summary: In accordance with the Paperwork Reduction Act of 1995 (44 
U.S.C. Chapter 35), the Railroad Retirement Board (RRB) is forwarding 
three Information Collection Requests (ICR) to the Office of 
Information and Regulatory Affairs (OIRA), Office of Management and 
Budget (OMB). Our ICR describes the information we seek to collect from 
the public. Review and approval by OIRA ensures that we impose 
appropriate paperwork burdens.
    The RRB invites comments on the proposed collections of information 
to determine (1) the practical utility of the collections; (2) the 
accuracy of the estimated burden of the collections; (3) ways to 
enhance the quality, utility, and clarity of the information that is 
the subject of collection; and (4) ways to minimize the burden of 
collections on respondents, including the use of automated collection 
techniques or other forms of information technology. Comments to the 
RRB or OIRA must contain the OMB control number of the ICR. For proper 
consideration of your comments, it is best if the RRB and OIRA receive 
them within 30 days of the publication date.
    1. Title and Purpose of information collection: Certification of 
Termination of Service and Relinquishment of Rights; OMB 3220-0016.
    Under Section 2(e)(2) of the Railroad Retirement Act (RRA), an age 
and service annuity, spouse annuity, or divorced spouse annuity cannot 
be paid unless the RRB has evidence that the applicant has ceased 
railroad employment and relinquished rights to return to the service of 
a railroad employer. The procedure pertaining to the relinquishment of 
rights by an annuity applicant is prescribed in 20 CFR 216.24. Under 
Section 2(f)(6) of the RRA, earnings deductions are required each month 
an annuitant works in certain nonrailroad employment termed Last Pre-
Retirement Non-Railroad Employment.
    Normally, the employee, spouse, or divorced spouse relinquishes 
rights and certifies that employment has ended as part of the annuity 
application process. However, this is not always the case. In limited 
circumstances, the RRB utilizes Form G-88, Certification of Termination 
of Service and Relinquishment of Rights, to obtain an applicant's 
report of termination of employment and relinquishment of rights. One 
response is required of each respondent. Completion is required to 
obtain or retain benefits.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (76 FR 24066 on April 29, 2011) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Certification of Termination of Service and Relinquishment 
of Rights.
    OMB Control Number: 3220-0016.
    Form(s) submitted: G-88.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or households.
    Abstract: Under Section 2(e)(2) of the Railroad Retirement Act, the 
Railroad Retirement Board must have evidence that an annuitant for an 
age and service, spouse, or divorced spouse annuity has ceased railroad 
employment and relinquished their rights to return to the service of a 
railroad employer. The collection provides the means for obtaining this 
evidence.
    Changes proposed: The RRB proposes no revisions to Form G-88.
    The burden estimate for the ICR is as follows:
    Estimated Completion Time for Form G-88 is estimated at 6 minutes.
    Estimated annual number of respondents: 3,600.
    Total annual responses: 3,600.
    Total annual reporting hours: 360.
    2. Title and Purpose of information collection: Statement of 
Authority to Act for Employee; OMB 3220-0034.
    Under Section 5(a) of the Railroad Unemployment Insurance Act 
(RUIA), claims for benefits are to be made in accordance with such 
regulations as the RRB shall prescribe. The provisions for claiming 
sickness benefits as provided by Section 2 of the RUIA are prescribed 
in 20 CFR 335.2. Included in these provisions is the RRB's acceptance 
of forms executed by someone else on behalf of an employee if the RRB 
is satisfied that the employee is sick or injured to the extent of 
being unable to sign forms.
    The RRB utilizes Form SI-10, Statement of Authority to Act for 
Employee, to provide the means for an individual to apply for authority 
to act on behalf of an incapacitated employee and also to obtain the 
information necessary to determine that the delegation should be made. 
Part I of the form is completed by the applicant for the authority and 
Part II is completed by the employee's doctor. One response is 
requested of each respondent. Completion is required to obtain 
benefits.

[[Page 41314]]

    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (76 FR 24066 on April 29, 2011) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Statement of Authority to Act for Employee.
    OMB Control Number: 3220-0034.
    Form(s) submitted: SI-10.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or households.
    Abstract: Under 20 CFR 335.2, the Railroad Retirement Board (RRB) 
accepts claims for sickness benefits by other than the sick or injured 
employees, provided the RRB has the information needed to satisfy 
itself that the delegation should be made.
    Changes proposed: The RRB proposes no changes to Form SI-10.
    The burden estimate for the ICR is as follows:
    Estimated Completion Time for Form SI-10 is estimated at 6 minutes.
    Estimated annual number of respondents: 400.
    Total annual responses: 400.
    Total annual reporting hours: 40.
    3. Title and Purpose of information collection: Statement Regarding 
Contributions and Support; OMB 3220-0099.
    Under Section 2 of the Railroad Retirement Act, dependency on an 
employee for one-half support at the time of the employee's death can 
affect (1) entitlement to a survivor annuity when the survivor is a 
parent of the deceased employee; (2) the amount of spouse and survivor 
annuities; and (3) the Tier II restored amount payable to a widow(er) 
whose annuity was reduced for receipt of an employee annuity, and who 
was dependent on the railroad employee in the year prior to the 
employee's death. One-half support may also negate the public service 
pension offset in Tier I for a spouse or widow(er). The Railroad 
Retirement Board (RRB) utilizes Form G-134, Statement Regarding 
Contributions and Support, to secure information needed to adequately 
determine if the applicant meets the one-half support requirement. One 
response is requested of each respondent. Completion is required to 
obtain benefits.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (76 FR 24066 on April 29, 2011) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Statement Regarding Contributions and Support.
    OMB Control Number: 3220-0099.
    Form(s) submitted: G-134.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or households.
    Abstract: Dependency on the employee for one-half support at the 
time of the employee's death can be a condition affecting eligibility 
for a survivor annuity provided for under Section 2 of the Railroad 
Retirement Act. One-half support is also a condition which may negate 
the public service pension offset in Tier I for a spouse or widow(er).
    Changes proposed: The RRB proposes no revisions to Form G-134.
    The burden estimate for the ICR is as follows:
    Estimated Completion Time for Form G-134 is estimated at 147 
minutes with assistance to 180 minutes without assistance.
    Estimated annual number of respondents: 100.
    Total annual responses: 100.
    Total annual reporting hours: 259.
    Additional Information or Comments: Copies of the forms and 
supporting documents can be obtained from Charles Mierzwa, the agency 
clearance officer at (312) 751-3363 or [email protected].
    Comments regarding the information collection should be addressed 
to Patricia Henaghan, Railroad Retirement Board, 844 North Rush Street, 
Chicago, Illinois, 60611-2092 or [email protected] and to the 
OMB Desk Officer for the RRB, Fax: 202-395-6974, E-mail address: [email protected].

Charles Mierzwa,
Clearance Officer.
[FR Doc. 2011-17644 Filed 7-12-11; 8:45 am]
BILLING CODE 7905-01-P