United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information executive 2017-01-09 article Part VIII UNKNOWN D09002ee1be06fb85 United States Office of Personnel Management originator org United States Government Agency or Subagency In accordance with the Paperwork Reduction Act of 1980 (title 44, U.S. Code, chapter 35), this notice announces a request for a reclearance of an information collection. SF 3104, Application for Death Benefits (FERS), is needed for the Office of Personnel Management to determine whether death benefits should be paid, to whom, and in what amount. SF 3104A (attached to SF 3104), requests information from the survivor which is used by OPM to determine entitlement to a survivor annuity supplement (supplementary annuity). SF 3104B is used by the deceased employee's former employing agency in death-in-service cases, to supply the survivor's application for death benefits (SF 3104). Approximately 3,546 SF 3104s are completed annually. We estimate that it takes 60 minutes to fill out the form. The annual burden is 3,546 hours. Approximately 2,766 SF 3104Bs are completed annually. We estimate that it takes 60 minutes to fill out the form. The annual burden is 2,766 hours. The combined total annual burden is 6,312 hours. For copies of this proposal, contact C. Ronald Trueworthy on (703) 908-8550. 59 FR https://www.govinfo.gov/app/details/FR-1994-06-28/94-15480 94-15480 fr28jn94-103 6325-01-M Federal Register: June 28, 1994 https://www.govinfo.gov/app/details/FR-1994-06-28/94-15480 https://www.govinfo.gov/content/pkg/FR-1994-06-28/html/94-15480.htm 59 FR Notice of Request for Reclearance of SF 3104, SF 3104A, and SF 3104B; Federal Register Vol. 59, Issue UNKNOWN 94-15480 VIII OFFICE OF PERSONNEL MANAGEMENT Federal Register: June 28, 1994 6325-01-M 94-15480 Notice.

In accordance with the Paperwork Reduction Act of 1980 (title 44, U.S. Code, chapter 35), this notice announces a request for a reclearance of an information collection. SF 3104, Application for Death Benefits (FERS), is needed for the Office of Personnel Management to determine whether death benefits should be paid, to whom, and in what amount. SF 3104A (attached to SF 3104), requests information from the survivor which is used by OPM to determine entitlement to a survivor annuity supplement (supplementary annuity). SF 3104B is used by the deceased employee's former employing agency in death-in-service cases, to supply the survivor's application for death benefits (SF 3104). Approximately 3,546 SF 3104s are completed annually. We estimate that it takes 60 minutes to fill out the form. The annual burden is 3,546 hours. Approximately 2,766 SF 3104Bs are completed annually. We estimate that it takes 60 minutes to fill out the form. The annual burden is 2,766 hours. The combined total annual burden is 6,312 hours. For copies of this proposal, contact C. Ronald Trueworthy on (703) 908-8550.

Comments on this proposal should be received within 30 calendar days from the date of this publication. Vol. 59, no. 123 Office of the Federal Register, National Archives and Records Administration 1994-06-28 continuing daily deposited born digital 236 p. AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-1994-06-28 P0b002ee193435911 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr28jn94 https://www.govinfo.gov/app/details/FR-1994-06-28 https://www.govinfo.gov/content/pkg/FR-1994-06-28/pdf/FR-1994-06-28.pdf fdlp 33193 33412 DGPO 2017-01-09 2023-05-07 FR-1994-06-28 machine generated eng FR FR-1994-06-28 59 123 true