[Federal Register Volume 77, Number 5 (Monday, January 9, 2012)]
[Notices]
[Pages 1093-1095]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-190]


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RAILROAD RETIREMENT BOARD


Proposed Collection; Comment Request

SUMMARY: In accordance with the requirement of Section 3506 (c)(2)(A) 
of the Paperwork Reduction Act of 1995 which provides opportunity for 
public comment on new or revised data collections, the Railroad 
Retirement Board (RRB) will publish periodic summaries of proposed data 
collections.
    Comments are invited on: (a) Whether the proposed information 
collection is necessary for the proper performance of the functions of 
the agency, including whether the information has practical utility; 
(b) the accuracy of the RRB's estimate of the burden of the collection 
of the information; (c) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (d) ways to minimize 
the burden related to the collection of information on respondents, 
including the use of automated collection techniques or other forms of 
information technology.
    1. Title and purpose of information collection: Application for 
Employee Annuity Under the Railroad Retirement Act; OMB 3220-0002.
    Section 2a of the Railroad Retirement Act (RRA) provides for 
payments of age and service, disability, and supplemental annuities to 
qualified employees. An annuity cannot be paid until the employee stops 
working for a railroad employer. In addition, the age and service 
employee must relinquish any rights held to such jobs. A disabled 
employee does not need to relinquish employee rights until attaining 
Full Retirement Age, or if earlier, when their spouse files for a 
spouse annuity. Benefits become payable after the employee meets 
certain other requirements, which depend on the type of annuity 
payable. The requirements for obtaining the annuities are prescribed in 
20 CFR parts 216 and 220.
    To collect the information needed to help determine an applicant's 
entitlement to, and the amount of, an employee retirement annuity the 
RRB uses Forms AA-1, Application for Employee Annuity; AA-1d, 
Application for Determination of Employee Disability; G-204, 
Verification of Workers Compensation/Public Disability Benefit 
Information and electronic Form AA-1cert, Application Summary and 
Certification.
    The AA-1 application process obtains information from an applicant 
about their marital history, work history, military service, benefits 
from other governmental agencies, railroad pensions and Medicare 
entitlement for either an age and service or disability annuity. An RRB 
representative interviews the applicant either at a field office 
(preferred), an itinerant point, or by telephone. During the interview, 
the RRB representative enters the information obtained into an on-line 
information system. Upon completion of the interview, the on-line 
information system generates, for the applicant's review and 
traditional pen and ink ``wet'' signature, Form AA-1cert, Application 
Summary and Certification, which summarizes the information that was 
provided or verified by the applicant. When the RRB representative is 
unable to contact the applicant in person or by telephone, for example, 
the applicant lives in another country, a manual version of Form AA-1 
is used.
    Form AA-1d, Application for Determination of Employee's Disability, 
is completed by an employee who is filing for a disability annuity 
under the RRA, or a disability freeze under the Social Security Act, 
for early Medicare based on a disability. Form G-204, Verification of 
Worker's Compensation/Public Disability Benefit Information, is used to 
obtain and verify information concerning a worker's compensation or a 
public disability benefit that is or will be paid by a public agency to 
a disabled railroad employee. The RRB proposes no changes to Forms AA-
1d or G-204.
    Consistent with 20 CFR 217.17, upon completion of the AA-1 
interview process, the RRB proposes to provide, in addition to the 
current Form AA-1cert pen and ink ``wet'' signature, an alternate 
signing method called ``Attestation,'' which will be documented by new 
form AA-1sum. Attestation refers to an action taken by the RRB 
representative to confirm and annotate in the RRB records (1) the 
applicant's intent to file an application; (2) the applicant's 
affirmation under penalty of perjury that the information provided is 
correct; and (3) the applicant's agreement to sign the application by 
proxy. The information collected as part of the AA-1 interview process 
will be the same irrespective of whether the application is signed by a 
pen and ink ``wet'' signature or by attestation. The only difference 
will be the method of signature.
    In addition, consistent with Department of Treasury guidelines, the 
RRB proposes revisions to Forms AA-1 and AA-1cert to provide claimants 
a Direct Express[reg] Master Card[reg] Debit Card payment option. Other 
non-burden-impacting editorial and formatting changes are proposed. One 
response is requested of each respondent. Completion of the forms is 
required to obtain a benefit.

                                      Estimate of Annual Respondent Burden
                             [The estimated annual respondent burden is as follows]
----------------------------------------------------------------------------------------------------------------
                                                                      Annual           Time           Burden
                            Form No.                                 responses       (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
AA-1 (without assistance).......................................             100              62             103
AA-1cert (with assistance)......................................           4,900              30           2,450
AA-1sum (with assistance).......................................           9,100              29           4,398
AA-1d (with assistance).........................................           3,700              35           2,158

[[Page 1094]]

 
AA-1d (without assistance)......................................               5              60               5
G-204...........................................................              20              15               5
                                                                 =================
    Total.......................................................          17,825  ..............           9,119
----------------------------------------------------------------------------------------------------------------

    2. Title and purpose of information collection: Application for 
Survivor Insurance Annuities; OMB 3220-0030.
    Under Section 2(d) of the Railroad Retirement Act (RRA), monthly 
survivor annuities are payable to surviving widow(er)s, parents, 
unmarried children, and in certain cases, divorced spouses, mothers 
(fathers), remarried widow(er)s, and grandchildren of deceased railroad 
employees if there are no qualified survivors of the employee 
immediately eligible for an annuity. The requirements relating to the 
annuities are prescribed in 20 CFR 216, 217, 218, and 219.
    To collect the information needed to help determine an applicant's 
entitlement to, and the amount of, a survivor annuity the RRB uses 
Forms AA-17, Application for Widow(er)'s Annuity; AA-17b, Applications 
for Determination of Widow(er)'s Disability; AA-18, Application for 
Mother's/Father's and Child's Annuity; AA-19, Application for Child's 
Annuity; AA-19a, Application for Determination of Child's Disability; 
AA-20, Application for Parent's Annuity, and electronic Form AA-17cert, 
Application Summary and Certification.
    The AA-17 application process obtains information from an applicant 
about their marital history, work history, benefits from other 
government agencies, and Medicare entitlement for a survivor annuity. 
An RRB representative interviews the applicant either at a field office 
(preferred), an itinerant point, or by telephone. During the interview, 
the RRB representative enters the information obtained into an on-line 
information system. Upon completion of the interview, the system 
generates, for the applicant's review and traditional pen and ink 
``wet'' signature, Form AA-17cert, Application Summary and 
Certification, which is a summary of the information that the applicant 
provided or verified. When the RRB representative is unable to contact 
the applicant in person or by telephone, for example, the applicant 
lives in another country, a manual version of Form AA-17 is used.
    Consistent with 20 CFR 217.17, upon completion of the AA-17 
interview process, the RRB proposes to provide, in addition to the 
current Form AA-17cert pen and ink ``wet'' signature, an alternate 
signing method called ``Attestation,'' which will be documented by new 
form AA-17sum. Attestation refers to an action taken by the RRB 
representative to confirm and annotate in the RRB records (1) the 
applicant's intent to file an application; (2) the applicant's 
affirmation under penalty of perjury that the information provided is 
correct; and (3) the applicant's agreement to sign the application by 
proxy. The information collected as part of the AA-17 interview process 
will be the same irrespective of whether the application is signed by a 
pen and ink ``wet'' signature or by attestation. The only difference 
will be the method of signature.
    In addition, consistent with Department of Treasury guidelines, the 
RRB proposes revisions to Forms AA-17, AA-17cert, AA-18, AA-19, and AA-
20 cert to provide claimants a Direct Express[reg] Master Card[reg] 
Debit Card payment option. Other non-burden-impacting editorial and 
formatting changes are proposed. No changes are proposed to Forms AA-
17b and AA-19a. One response is requested of each respondent. 
Completion of the forms is required to obtain a benefit.

                                      Estimate of Annual Respondent Burden
                             [The estimated annual respondent burden is as follows]
----------------------------------------------------------------------------------------------------------------
                                                                      Annual           Time           Burden
                            Form No.                                 responses       (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
AA-17 (without assistance)......................................             100              47              78
AA-17b (with assistance)........................................             280              40             187
AA-17b (without assistance).....................................              20              50              17
AA-17cert (with assistance).....................................             900              20             300
AA-17sum (with assistance)......................................           2,100              19             665
AA-18 (without assistance)......................................              12              47               9
AA-19 (without assistance)......................................               9              47               7
AA-19a (with assistance)........................................             285              45             214
AA-19a (without assistance).....................................              15              65              16
AA-20 (without assistance)......................................               1              47               1
                                                                 -----------------------------------------------
    Total.......................................................           3,722  ..............           1,494
----------------------------------------------------------------------------------------------------------------

    3. Title and purpose of information collection: Application for 
Spouse Annuity Under the Railroad Retirement Act; OMB 3220-0042.
    Section 2(c) of the Railroad Retirement Act (RRA), provides for the 
payment of annuities to spouses of railroad retirement annuitants who 
meet the requirements under the RRA. The age requirements for a spouse 
annuity depend on the employee's age, date of retirement, and years of 
railroad service. The requirements relating to the annuities are 
prescribed in 20 CFR parts 216, 218, 219, 232, 234, and 295.
    To collect the information needed to help determine an applicant's 
entitlement to, and the amount of, a

[[Page 1095]]

spouse annuity the RRB uses Form AA-3, Application for Spouse/Divorced 
Spouse Annuity, and electronic Form AA-3cert, Application Summary and 
Certification.
    The AA-3 application process gathers information from an applicant 
about their marital history, work history, benefits from other 
government agencies, railroad pensions and Medicare entitlement for a 
spouse annuity. An RRB representative interviews the applicant either 
at a field office (preferred), an itinerant point, or by telephone. 
During the interview, the RRB representative enters the information 
obtained into an on-line information system. Upon completion of the 
interview, the system generates, for the applicant's review and 
traditional pen and ink ``wet'' signature, Form AA-3cert, Application 
Summary and Certification, which is a summary of the information that 
the applicant provided or verified. When the RRB representative is 
unable to contact the applicant in person or by telephone, for example, 
the applicant lives in another country, a manual version of Form AA-3 
is used.
    Consistent with 20 CFR 217.17, upon completion of the AA-3 
interview process, the RRB proposes to provide, in addition to the 
current Form AA-3cert pen and ink ``wet'' signature, an alternate 
signing method called ``Attestation,'' which will be documented by new 
Form AA-3sum. Attestation refers to an action taken by the RRB 
representative to confirm and annotate in the RRB records (1) the 
applicant's intent to file an application; (2) the applicant's 
affirmation under penalty of perjury that the information provided is 
correct; and (3) the applicant's agreement to sign the application by 
proxy. The information collected as part of the AA-3 interview process 
will be the same irrespective of whether the application is signed by a 
pen and ink ``wet'' signature or by attestation. The only difference 
will be the method of signature.
    In addition, consistent with Department of Treasury guidelines, the 
RRB proposes revisions to Forms AA-3 and AA-3cert, to provide claimants 
a Direct Express[supreg] Master Card[supreg] Debit Card payment option. 
Other non-burden-impacting editorial and formatting changes are 
proposed. One response is requested of each respondent. Completion of 
the forms is required to obtain a benefit.

                                      Estimate of Annual Respondent Burden
                             [The estimated annual respondent burden is as follows]
----------------------------------------------------------------------------------------------------------------
                                                                      Annual           Time           Burden
                            Form No.                                 responses       (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
AA-3 (without assistance).......................................             250              58             242
AA-3cert (with assistance)......................................           3,700              30           1,850
AA-3sum (with assistance).......................................           7,100              29           3,432
                                                                 -----------------------------------------------
    Total.......................................................          11,050  ..............           5,524
----------------------------------------------------------------------------------------------------------------

    Additional Information or Comments: To request more information or 
to obtain a copy of the information collection justification, forms, 
and/or supporting material, contact Charles Mierzwa, the RRB 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 emailed to [email protected]. Written 
comments should be received within 60 days of this notice.

Charles Mierzwa,
Clearance Officer.
[FR Doc. 2012-190 Filed 1-6-12; 8:45 am]
BILLING CODE 7905-01-P