[Federal Register Volume 77, Number 125 (Thursday, June 28, 2012)] [Notices] [Pages 38681-38682] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 2012-15856] ----------------------------------------------------------------------- OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Health Benefits Election Form, OPM 2809 AGENCY: U.S. Office of Personnel Management. ACTION: 60-day notice and request for comments. ----------------------------------------------------------------------- [[Page 38682]] SUMMARY: The Retirement Services, Office of Personnel Management (OPM) offers the general public and other federal agencies the opportunity to comment on a revised information collection request (ICR) 3206-0141, Health Benefits Election Form. As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. chapter 35) as amended by the Clinger-Cohen Act (Pub. L. 104-106), OPM is soliciting comments for this collection. The Office of Management and Budget is particularly interested in comments that: 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. DATES: Comments are encouraged and will be accepted until August 27, 2012. This process is conducted in accordance with 5 CFR 1320.1. ADDRESSES: Interested persons are invited to submit written comments on the proposed information collection to U.S. Office of Personnel Management, Attention: Alberta Butler, Union Square Room US 370, 1900 E Street NW., Washington, DC 20415-3500, or sent via electronic mail to [email protected]. FOR FURTHER INFORMATION CONTACT: A copy of this ICR with applicable supporting documentation, may be obtained by contacting the Retirement Services Publications Team, U.S. Office of Personnel Management, 1900 E Street NW., Room 4332, Washington, DC 20415, Attention: Cyrus S. Benson, or sent via electronic mail to [email protected] or faxed to (202) 606-0910. SUPPLEMENTARY INFORMATION: OPM 2809 is used by annuitants and former spouses to elect, cancel, suspend, or change health benefits enrollment during periods other than open season. Analysis Agency: Retirement Operations, Retirement Services, Office of Personnel Management. Title: Health Benefits Election Form. OMB Number: 3206-0141. Frequency: On occasion. Affected Public: Individuals or Households. Number of Respondents: 30,000. Estimated Time per Respondent: 30 minutes. Total Burden Hours: 15,000 hours. U.S. Office of Personnel Management. John Berry, Director. [FR Doc. 2012-15856 Filed 6-27-12; 8:45 am] BILLING CODE 6325-38-P