Submission for OMB Review; Comment Request for Reclearance of a Revised Information Collection: RI 78-11

AGENCY:

Office of Personnel Management.

ACTION:

Notice.

SUMMARY:

In accordance with the Paperwork Reduction Act of 1995 (Public Law 104-13, May 22, 1995), this notice announces that the Office of Personnel Management (OPM) has submitted to the Office of Management and Budget a request for reclearance of a revised information collection. RI 78-11, Medicare Part B Certification, collects information from annuitants, their spouses, and survivor annuitants to determine their eligibility under the Retired Federal Employees Health Benefits Program for a Government contribution toward the cost of Part B of Medicare.

Approximately 100 RI 78-11 forms are completed annually. Each form requires approximately 10 minutes to complete for an annual estimated burden of 17 hours.

For copies of this proposal, contact Mary Beth Smith-Toomey on (202) 606-8358, FAX 202-418-3251, or via E-mail at mbtoomey@opm.gov. Please include a mailing address with your request.

DATES:

Comments on this proposal should be received on or before July 18, 2002.

ADDRESSES:

Send or deliver comments to:

Ronald W. Melton, Chief, Operations Support Division, Retirement and Insurance Service, U.S. Office of Personnel Management, 1900 E Street, NW., Room 3349, Washington, DC 20415; and

Joseph Lackey, OPM Desk Officer, Office of Information & Regulatory Affairs, Office of Management and Budget, New Executive Office Building, NW., Room 10235, Washington, DC 20503.

FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION CONTACT:

Cyrus S. Benson, Team Leader, Desktop Publishing & Printing Team, Budget & Administrative Services Division, (202) 606-0623.