67 FR 139 pgs. 47577-47578 - Agency Forms Submitted for OMB Review

Type: NOTICEVolume: 67Number: 139Pages: 47577 - 47578
FR document: [FR Doc. 02-18231 Filed 7-18-02; 8:45 am]
Agency: Railroad Retirement Board
Official PDF Version:  PDF Version


Agency Forms Submitted for OMB Review


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.

Summary of Proposals(s)

(1) Collection title: Statement of Authority.

(2) Form(s) submitted: SI-10.

(3) OMB Number: 3220-0034.

(4) Expiration date of current OMB clearance: 11/30/2002.

(5) Type of request: Extension of a currently approved collection.

(6) Respondents: Individuals or households, Business or other for-profit.

(7) Estimated annual number of respondents: 400.

(8) Total annual responses: 400.

(9) Total annual reporting hours: 40.

(10) Collection description: Under 20 CFR 355.2, the Railroad Retirement Board (RRB) accepts claims for sickness benefits by other than the sick or injured employees, provided the RRB has the information needed to satisfy itself that the delegation should be made.

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 to the OMB Desk Officer for the RRB, at the Office of Management and Budget, Room 10230, New Executive Office Building, Washington, DC 20503.

Chuck Mierzwa,

Clearance Officer.

[FR Doc. 02-18231 Filed 7-18-02; 8:45 am]