[Federal Register Volume 77, Number 224 (Tuesday, November 20, 2012)]
[Notices]
[Pages 69665-69666]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-28124]
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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
two 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: Survivor
Questionnaire; OMB 3220-0032.
Under Section 6 of the Railroad Retirement Act (RRA), benefits that
may be due on the death of a railroad employee or a survivor annuitant
include (1) a lump-sum death benefit (2) a residual lump-sum payment
(3) accrued annuities due but unpaid at death, and (4) monthly survivor
insurance payments. The requirements for determining the entitlement of
possible beneficiaries to these benefits are prescribed in 20 CFR 234.
When the Railroad Retirement Board (RRB) receives notification of
the death of a railroad employee or survivor annuitant, an RRB field
office utilizes Form RL-94-F, Survivor Questionnaire, to secure
additional information from surviving relatives needed to determine if
any further benefits are payable under the RRA. Completion is
voluntary. One response is requested of each respondent.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (77 FR 51834 on August 27, 2012) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.
Information Collection Request (ICR)
Title: Survivor Questionnaire .
OMB Control Number: 3220-0032.
Form(s) submitted: RL-94-F.
Type of request: Revision of a currently approved collection.
Affected public: Individuals or Households.
Abstract: Under Section 6 of the Railroad Retirement Act, benefits
are payable to the survivors of the estates of deceased railroad
employees. The collection obtains information used to determine if and
to whom benefits are payable; such as a widow(er) due survivor
benefits, an executor of the estate, or a payer of burial expenses.
Changes proposed: The RRB proposes collecting identifying
information when a trustee pays the burial expenses; minor non-burden
impacting clarification; and editorial changes to Form RL-94-F.
The burden estimate for the ICR is as follows:
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Annual Time Burden
Form No. responses (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
RL-94-F, Items 5-10, and 18..................................... 50 9 8
RL-94-F, Items 5-18............................................. 7,200 11 1,320
RL-94-F, Item 18 only........................................... 750 5 63
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Total....................................................... 8,000 .............. 1,391
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[[Page 69666]]
2. Title and Purpose of information collection: Request for
Medicare Payment; OMB 3220-0131.
Under Section 7(d) of the Railroad Retirement Act, the RRB
administers the Medicare program for persons covered by the railroad
retirement system. The collection obtains the information needed by
Palmetto GBA, the Medicare carrier for railroad retirement
beneficiaries, to pay claims for payments under Part B of the Medicare
program. Authority for collecting the information is prescribed in 42
CFR 424.32.
The RRB currently utilizes Forms G-740S, Patient's Request for
Medicare Payment, along with Centers for Medicare & Medicaid Services
Form CMS-1500, to secure the information necessary to pay Part B
Medicare Claims. One response is completed for each claim. Completion
is required to obtain a benefit.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (77 FR 51834 on September 4, 2012) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.
Information Collection Request (ICR)
Title: Request for Medicare Payment.
OMB Control Number: 3220-0131.
Form(s) submitted: G-740S, CMS-1500.
Type of request: Revision of a currently approved collection.
Affected public: Individuals or Households.
Abstract: The RRB administers the Medicare program for persons
covered by the Railroad Retirement System. The collection obtains the
information needed by Palmetto GBA, the RRB's carrier, to pay claims
for services covered under Part B of the program.
Changes proposed: The RRB is proposing minor, non-burden impacting
editorial and cosmetic changes to RRB Form G-740S.
The burden estimate for the ICR is as follows:
Estimated annual number of respondents: See Justification (Item No.
12).
Total annual responses: 1.
Total annual reporting hours: 1.
3. Title and Purpose of information collection: Employer's Deemed
Service Month Questionnaire; OMB 3220-0156.
Section 3(i) of the Railroad Retirement Act (RRA), as amended by
Public Law 98-76, provides that the Railroad Retirement Board (RRB),
under certain circumstances, may deem additional months of service in
cases where an employee does not actually work in every month of the
year, provided the employee satisfies certain eligibility requirements,
including the existence of an employment relation between the employee
and his or her employer. The procedures pertaining to the deeming of
additional months of service are found in the RRB's regulations at 20
CFR 210, Creditable Railroad Service.
The RRB utilizes Form GL-99, Employer's Deemed Service Months
Questionnaire, to obtain service and compensation information from
railroad employers to determine if an employee can be credited with
additional deemed months of railroad service. Completion is mandatory.
One response is required for each RRB inquiry.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (77 FR 51834 on August 27, 2012) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.
Information Collection Request (ICR)
Title: Employer's Deemed Service Month Questionnaire.
OMB Control Number: 3220-0156.
Form(s) submitted: GL-99.
Type of request: Revision of a currently approved collection.
Affected public: Individuals or Households.
Abstract: Under Section 3(i) of the Railroad Retirement Act, the
Railroad Retirement Board may deem months of service in cases where an
employee does not actually work in every month of the year. The
collection obtains service and compensation information from railroad
employers needed to determine if an employee may be credited with
additional months of railroad service.
Changes proposed: The RRB is proposing revisions to Form GL-99 to
obtain only a ``Yes'' or ``No'' response regarding whether an employee
was in an employment relationship with an employer during any months
indicated on the GL-99 as not worked. Other minor non-burden impacting
editorial changes are also proposed.
The burden estimate for the ICR is as follows:
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Annual
Form No. responses Time (minutes) Burden (hours)
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GL-99........................................................ 4,000 2 133
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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. 2012-28124 Filed 11-19-12; 8:45 am]
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