[Federal Register Volume 80, Number 230 (Tuesday, December 1, 2015)]
[Notices]
[Pages 75140-75141]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-30443]


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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 
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 Forms AA-
17cert, Application Summary and Certification and AA-17sum, Application 
Summary.
    The on-line automated survivor annuity application (Forms AA-17, 
AA-18, AA-19, and AA-20) process obtains information about an 
applicant's 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, either Form AA-17cert or AA-
17sum, which provides a summary of the information that the applicant 
provided or verified. Form AA-17cert, Application Summary and 
Certification, requires a tradition pen and ink ``wet'' signature. Form 
AA-17sum, Application Summary, documents the alternate signing method 
called ``Attestation,'' which is 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. 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 the appropriate form is used. One response 
is requested of each respondent. Completion of the forms is required to 
obtain a benefit.
    The RRB proposes to remove the paper version of Forms AA-17, AA-18, 
AA-19, and AA-20 from the information collection due to receiving less 
than 10 responses a year. No changes are proposed to electronic Forms 
AA-17cert, AA-17sum, or manual Forms AA-17b and AA-19a.

[[Page 75141]]



                                      Estimate of Annual Respondent Burden
----------------------------------------------------------------------------------------------------------------
                                                                      Annual           Time           Burden
                           Form number                               responses       (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
AA-17 Application Process
    AA-17cert...................................................             900              20             300
    AA-17sum....................................................           2,100              19             665
AA-17b
    (With assistance)...........................................             250              40             167
    (Without assistance)........................................              20              50              17
AA-19a
    (With assistance)...........................................             200              45             150
    (Without assistance)........................................              15              65              16
                                                                 -----------------------------------------------
        Total...................................................           3,485  ..............           1,315
----------------------------------------------------------------------------------------------------------------

    2. 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 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 spouse annuity the RRB uses Form 
AA-3, Application for Spouse/Divorced Spouse Annuity, and electronic 
Forms AA-3cert, Application Summary and Certification, and AA-3sum, 
Application Summary.
    The AA-3 application process gathers information from an applicant 
about their marital history, work history, benefits from other 
government agencies, 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, either Form AA-3cert or AA-3sum, 
which is a summary of the information that the applicant provided or 
verified. Form AA-3cert, Application Summary and Certification, 
requires a traditional pen and ink ``wet'' signature. Form AA-3sum, 
Application Summary, documents an alternate signing method called 
``Attestation,'' which is 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. 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. One response is requested of each 
respondent. Completion of the form is required to obtain a benefit.
    The RRB proposes to remove the paper version of the AA-3 from the 
information collection due to receiving less than 10 responses a year.

                                      Estimate of Annual Respondent Burden
----------------------------------------------------------------------------------------------------------------
                                                                      Annual           Time           Burden
                           Form number                               responses       (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Form AA-3 Online Process
    Form AA-3cert (Ink Signature)...............................           4,700              30           2,350
    Form AA-3sum (Attestation)..................................           7,000              29           3,383
                                                                 -----------------------------------------------
        Total...................................................          11,700  ..............           5,733
----------------------------------------------------------------------------------------------------------------

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

Charles Mierzwa,
Chief of Information Resources Management.
[FR Doc. 2015-30443 Filed 11-30-15; 8:45 am]
BILLING CODE 7905-01-P