[Federal Register Volume 64, Number 234 (Tuesday, December 7, 1999)]
[Pages 68396-68397]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-31627]



Agency Forms Submitted for OMB Review

SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (44 
U.S.C. Chapter 35), the Railroad Retirement Board (RRB) has submitted 
the following proposal(s) for the collection of information to the 
Office of Management and Budget for review and approval.


    (1) Collection title: Application for Survivor Death Benefits.
    (2) Form(s) submitted: AA-21, G-273a, AA-11a, G-131, and AA-21cert.
    (3) OMB Number: 3220-0031.
    (4) Expiration date of current OMB clearance: 2/28/2000.
    (5) Type of request: Revision of a currently approved collection.
    (6) Respondents: Individuals or Households, Business or other for-
    (7) Estimated annual number of respondents: 20,600.
    (8) Total annual responses: 20,600.
    (9) Total annual reporting hours: 5,150.
    (10) Collection description: The collection obtains the information 
needed to pay death benefits and annuities due but unpaid at death 
under the Railroad Retirement Act. Benefits are paid to designated 
beneficiaries or to survivors in a priority designated by law.

ADDITIONAL INFORMATION OR COMMENTS: Copies of the forms and supporting 
documents can be obtained from Chuck Mierzwa, the agency clearance 
officer (312-751-3363). Comments regarding the information collection 
should be addressed to Ronald J. Hodapp, Railroad Retirement Board, 844 
North Rush Street, Chicago, Illinois 60611-2092 and the OMB reviewer, 
Lori Schack (202-395-7316), Office of Management and

[[Page 68397]]

Budget, Room 10230, New Executive Office Building, Washington, DC 
Chuck Mierzwa,
Clearance Officer.
[FR Doc. 99-31627 Filed 12-6-99; 8:45 am]