[Federal Register Volume 87, Number 34 (Friday, February 18, 2022)]
[Notices]
[Pages 9397-9398]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-03580]


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OFFICE OF PERSONNEL MANAGEMENT


Information Collection: Application for Death Benefits Under the 
Federal Employees' Retirement System (SF 3104); and Documentation and 
Elections in Support of Application for Death Benefits When Deceased 
Was an Employee at the Time of Death (SF 3104B)

AGENCY: Office of Personnel Management.

ACTION: 60-Day notice and request for comments.

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SUMMARY: Retirement Services, Office of Personnel Management (OPM) 
offers the general public and other federal agencies the opportunity to 
comment on an expiring information collection (ICR), Application for 
Death Benefits under the Federal Employees' Retirement System (SF 
3104); and Documentation and Elections in Support of Application for 
Death Benefits When Deceased Was an Employee at the Time of Death (SF 
3104B).

DATES: Comments are encouraged and will be accepted until April 19, 
2022.

ADDRESSES: You may submit comments, identified by docket number and/or 
Regulatory Information Number (RIN) and title, by the following method:
    Federal Rulemaking Portal: http://www.regulations.gov. Follow the 
instructions for submitting comments. All submissions received must 
include the agency name and docket number or RIN for this document. The 
general policy for comments and other submissions from members of the 
public is to make these submissions available for public viewing at 
http://www.regulations.gov as they are received without change, 
including any personal identifiers or contact information.

FOR FURTHER INFORMATION CONTACT: A copy of this information collection 
instrument with applicable supporting documentation may be obtained by 
contacting the Retirement Services Publications Team, Office of 
Personnel Management, 1900 E Street NW, Room 3316-L, Washington, DC 
20415, Attention: Cyrus S. Benson, or sent via electronic mail to 
[email protected] or via telephone at (202) 606-4808.

SUPPLEMENTARY INFORMATION: As required by the Paperwork Reduction Act 
of 1995 (Pub. L. 104-13, 109 Stat. 106 (May 22, 1995), codified at 44 
U.S.C. chapter 35), OPM is soliciting comments for this collection (OMB 
No. 3206-0172). We are particularly interested in comments that do the 
following:
    1. Evaluate whether the proposed collection of information is 
necessary for the proper performance of functions of the agency, 
including whether the information will have practical utility;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected; and
    4. Minimize the burden of the collection of information on those 
who are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology (e.g., permitting electronic 
submissions of responses).
    The form SF 3104, Application for Death Benefits Under the Federal 
Employees' Retirement System, is needed to collect information so that 
OPM can pay death benefits to survivors of Federal employees and 
annuitants. The form SF 3104B, Documentation in Support of Application 
for Death Benefits When Deceased Was an Employee at the Time of Death, 
is needed for deaths in service so that survivors may make elections 
regarding health benefits, payment of post-1956

[[Page 9398]]

military service deposits, and payment methods for death benefits.

Analysis

    Agency: Retirement Operations, Retirement Services, Office of 
Personnel Management
    Title: Application for Death Benefits under the Federal Employees' 
Retirement System and Documentation and Elections in Support of 
Application for Death Benefits When Deceased Was an Employee at the 
Time of Death.
    OMB Number: 3206-0172.
    Frequency: On occasion.
    Affected Public: Individuals or Households.
    Number of Respondents: SF 3104 = 12,734 and SF 3104B = 4,017.
    Estimated Time per Respondent: 60 minutes.
    Total Burden Hours: 16,751 hours.

Office of Personnel Management.
Kellie Cosgrove Riley,
Director, Office of Privacy and Information Management.
[FR Doc. 2022-03580 Filed 2-17-22; 8:45 am]
BILLING CODE 6325-38-P