[Federal Register Volume 79, Number 142 (Thursday, July 24, 2014)]
[Notices]
[Pages 43104-43105]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-17406]


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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: 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 Railroad Retirement Board (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.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (79 FR 26469 on May 8, 2014) 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:

----------------------------------------------------------------------------------------------------------------
                                                                    Annual
                           Form No.                               responses     Time  (minutes)  Burden  (hours)
----------------------------------------------------------------------------------------------------------------
SI-10........................................................             250                6               25
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    2. 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 completed by each respondent. Completion is required to 
obtain benefits.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (79 FR 26469 on May 8, 2014) 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.

[[Page 43105]]

    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 changes to Form G-134.
    The burden estimate for the ICR is as follows:

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                                                                      Annual           Time           Burden
                            Form No.                                 responses       (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
G-134:
    With Assistance.............................................              75             147             184
    Without assistance..........................................              25             180              75
                                                                 -----------------------------------------------
        Total...................................................             100  ..............             259
----------------------------------------------------------------------------------------------------------------

    3. Title and Purpose of information collection: Employee Non-
Covered Service Pension Questionnaire; OMB 3220-0154.
    Section 215(a)(7) of the Social Security Act provides for a 
reduction in social security benefits based on employment not covered 
under the Social Security Act or the Railroad Retirement Act (RRA). 
This provision applies a different social security benefit formula to 
most workers who are first eligible after 1985 to both a pension based 
in whole or in part on non-covered employment and a social security 
retirement or disability benefit. There is a guarantee provision that 
limits the reduction in the social security benefit to one-half of the 
portion of the pension based on non-covered employment after 1956. 
Section 8011 of Public Law 100-647 changed the effective date of the 
onset from the first month of eligibility to the first month of 
concurrent entitlement to the non-covered service benefit and the RRA 
benefit.
    Section 3(a)(1) of the RRA provides that the Tier I benefit of an 
employee annuity shall be equal to the amount (before any reduction for 
age or deduction for work) the employee would receive if entitled to a 
like benefit under the Social Security Act. The reduction for a non-
covered service pension also applies to a Tier I portion of the 
employee annuity under the RRA when the annuity or non-covered service 
pension begins after 1985. Since the amount of a spouse's Tier I 
benefit is one-half of the employee's Tier I, the spouse annuity is 
also affected.
    Form G-209, Employee Non-Covered Service Pension Questionnaire, is 
used by the RRB to obtain needed information (1) from a railroad 
employee who while completing Form AA-1, Application for Employee 
Annuity (OMB No. 3220-0002), indicates entitlement to or receipt of a 
pension based on employment not covered under the Railroad Retirement 
Act or the Social Security Act; or (2) from a railroad employee when an 
independently-entitled divorced spouse applicant believes the employee 
to be entitled to a non-covered service pension. However, this 
development is unnecessary if RRB records indicate the employee has 30 
or more years of coverage; or (3) from an employee annuitant who 
becomes entitled to a pension based on employment not covered under the 
Railroad Retirement Act or the Social Security Act. One response is 
requested 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 (79 FR 26469 on May 8, 2014) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Employee Non-Covered Service Pension Questionnaire.
    OMB Control Number: 3220-0154.
    Form(s) submitted: G-209.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or Households.
    Abstract: Under Section 3 of the Railroad Retirement Act, the Tier 
I portion of an employee annuity may be subjected to a reduction for 
benefits received based on work not covered under the Social Security 
Act or Railroad Retirement Act. The questionnaire obtains the 
information needed to determine if the reduction applies and the amount 
of such reduction.
    Changes proposed: The RRB proposes no revisions to Form G-209.
    The burden estimate for the ICR is as follows:

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                                                                      Annual           Time           Burden
                            Form No.                                 responses       (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
G-209 (Partial Questionnaire)...................................              50               1               1
G-209 (Full Questionnaire)......................................             100               8              13
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        Total...................................................             150  ..............              14
----------------------------------------------------------------------------------------------------------------

    Additional Information or Comments: Copies of the forms and 
supporting documents can be obtained from Dana Hickman at (312) 751-
4981 or [email protected].
    Comments regarding the information collection should be addressed 
to Charles Mierzwa, 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, Email address: [email protected].

Charles Mierzwa,
Chief of Information Resources Management.
[FR Doc. 2014-17406 Filed 7-23-14; 8:45 am]
BILLING CODE 7905-01-P