Agency Forms Submitted for OMB Review, Request for Comments, 29123-29125 [2017-13370]
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29123
Federal Register / Vol. 82, No. 122 / Tuesday, June 27, 2017 / Notices
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 collection of information to
determine (1) the practical utility of the
collection; (2) the accuracy of the
estimated burden of the collection; (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.
Title and purpose of information
collection: Representative Payee
Monitoring; OMB 3220–0151.
Under Section 12 of the Railroad
Retirement Act (RRA), the RRB may pay
annuity benefits to a representative
payee when an employee, spouse, or
survivor annuitant is incompetent or a
minor. The RRB is responsible for
determining if direct payment to an
annuitant or a representative payee
would best serve the annuitant’s best
interest. The accountability
requirements authorizing the RRB to
conduct periodic monitoring of
representative payees, including a
written accounting of benefit payments
received, are prescribed in 20 CFR
266.7. The RRB utilizes the following
forms to conduct its representative
payee monitoring program.
Form G–99a, Representative Payee
Report, is used to obtain information
needed to determine whether the benefit
payments certified to the representative
payee have been used for the
annuitant’s current maintenance and
personal needs and whether the
representative payee continues to be
concerned with the annuitant’s welfare.
RRB Form G–99c, Representative Payee
Evaluation Report, is used to obtain
more detailed information from a
representative payee who fails to
complete and return Form G–99a or in
situations when the returned Form G–
99a indicates the possible misuse of
funds by the representative payee. Form
G–99c contains specific questions
concerning the representative payee’s
performance and is used by the RRB to
determine whether or not the
representative payee should continue in
that capacity.
In cases where the representative
payee does not have custody of the
annuitant, proposed Form G–106,
Statement of Care and Responsibility to
Annuitant, will be used to solicit
information about the representative
payee’s performance and the annuitant’s
well-being from the custodian of the
annuitant. The proposed form contains
specific questions concerning the
representative payee’s performance, and
will be used by the RRB to determine
whether or not the representative payee
should continue in that capacity.
Completion of the forms in this
collection is required to retain benefits.
Previous Requests for Comments: The
RRB has already published the initial
60-day notice (82 FR 19396 on April 27,
2017) required by 44 U.S.C. 3506(c)(2).
That request elicited no comments.
Information Collection Request (ICR)
Title: Representative Payee
Monitoring.
OMB Control Number: 3220–0151.
Forms submitted: G–99a, G–99c and
G–106.
Type of request: Revision of a
currently approved collection.
Affected public: Individuals or
Households.
Abstract: Under Section 12(a) of the
Railroad Retirement Act, the RRB is
authorized to select, make payments to,
and conduct transactions with an
annuitant’s relative or some other
person willing to act on behalf of the
annuitant as representative payee. If the
representative payee does not have
custody of the beneficiary, the RRB will
obtain the information from the
custodian for evaluation. The collection
obtains information needed to
determine if a representative payee is
handling benefit payments in the best
interest of the annuitant.
Changes proposed: The RRB proposes
no changes to Forms G–99a and G–99c.
However, we propose the
implementation of new Form G–106 to
the information collection.
The burden estimate for the ICR is as
follows:
Annual
responses
Form No.
Time
(minutes)
Burden
(hours)
5,400
300
120
500
18
24
31
10
1,620
120
62
83
Total ......................................................................................................................................
mstockstill on DSK30JT082PROD with NOTICES
G–99a (legal and all other, excepting parent for child) ...............................................................
G–99c (Parts I and II) ..................................................................................................................
G–99c (Parts I, II, and III) ............................................................................................................
G–106 ..........................................................................................................................................
6,320
........................
1,885
Additional Information or Comments:
Copies of the forms and supporting
documents can be obtained from Dana
Hickman at (312) 751–4981 or
Dana.Hickman@RRB.GOV.
Comments regarding the information
collection should be addressed to Brian
Foster, Railroad Retirement Board, 844
North Rush Street, Chicago, Illinois
60611–1275 or Brian.Foster@rrb.gov and
to the OMB Desk Officer for the RRB,
Fax: 202–395–6974, Email address:
OIRA_Submission@omb.eop.gov.
Brian D. Foster,
Clearance Officer.
[FR Doc. 2017–13448 Filed 6–26–17; 8:45 am]
BILLING CODE 7905–01–P
RAILROAD RETIREMENT BOARD
Agency Forms Submitted for OMB
Review, Request for Comments
In accordance with the Paperwork
Reduction Act of 1995 (44 U.S.C.
Chapter 35), the Railroad Retirement
Board (RRB) is forwarding an
VerDate Sep<11>2014
18:33 Jun 26, 2017
Jkt 241001
PO 00000
Frm 00102
Fmt 4703
Sfmt 4703
Information Collection Request (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
E:\FR\FM\27JNN1.SGM
27JNN1
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Federal Register / Vol. 82, No. 122 / Tuesday, June 27, 2017 / Notices
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: Financial Disclosure
Statement; OMB 3220–0127.
Under Section 10 of the Railroad
Retirement Act and Section 2(d) of the
Railroad Unemployment Insurance Act,
the RRB may recover overpayments of
annuities, pensions, death benefits,
unemployment benefits, and sickness
benefits that were made erroneously. An
overpayment may be waived if the
beneficiary was not at fault in causing
the overpayment and recovery would
cause financial hardship. The
regulations for the recovery and waiver
of erroneous payments are contained in
20 CFR 255 and CFR 340.
The RRB utilizes Form DR–423,
Financial Disclosure Statement, to
obtain information about the overpaid
beneficiary’s income, debts, and
expenses if that person indicates that
(s)he cannot make restitution for the
overpayment. The information is used
to determine if the overpayment should
be waived as wholly or partially
uncollectible. If waiver is denied, the
information is used to determine the
size and frequency of installment
payments. The beneficiary is made
aware of the overpayment by letter and
is offered a variety of methods for
recovery. One response is requested of
each respondent. Completion is
voluntary. However, failure to provide
the requested information may result in
a denial of the waiver request.
Previous Requests for Comments: The
RRB has already published the initial
60-day notice (82 FR 17298 on April 10,
2017) required by 44 U.S.C. 3506(c)(2).
That request elicited no comments.
Information Collection Request (ICR)
Title: Financial Disclosure Statement.
OMB Control Number: 3220–0127.
Form(s) submitted: DR–423.
Type of request: Extension without
change of a currently approved
collection.
Affected public: Individuals or
Households.
Abstract: Under the Railroad
Retirement and the Railroad
Unemployment Insurance Acts, the
Railroad Retirement Board has authority
to secure from an overpaid beneficiary
a statement of the individual’s assets
and liabilities if waiver of the
overpayment is requested.
Changes proposed: The RRB proposes
no changes to Form DR–423.
The burden estimate for the ICR is as
follows:
Form No.
Annual
responses
Time
(minutes)
Burden
(hours)
DR–423 ........................................................................................................................................
1,200
85
1,700
2. Title and purpose of information
collection: Representative Payee
Parental Custody Monitoring; OMB
3220–0176.
Under Section 12(a) of the Railroad
Retirement Act (RRA), the Railroad
Retirement Board (RRB) is authorized to
select, make payments to, and to
conduct transactions with, a
beneficiary’s relative or some other
person willing to act on behalf of the
beneficiary as a representative payee.
The RRB is responsible for determining
if direct payment to the beneficiary or
payment to a representative payee
would best serve the beneficiary’s
interest. Inherent in the RRB’s
authorization to select a representative
payee is the responsibility to monitor
the payee to assure that the beneficiary’s
interests are protected. The RRB utilizes
Form G–99D, Parental Custody Report,
to obtain information needed to verify
that a parent-for-child representative
payee still has custody of the child. One
response is required from each
respondent.
Previous Requests for Comments: The
RRB has already published the initial
60–day notice (82 FR 17298 on April 10,
2017) required by 44 U.S.C. 3506(c)(2).
That request elicited no comments.
Information Collection Request (ICR)
Title: Representative Payee Parental
Custody Monitoring.
OMB Control Number: 3220–0176.
Form(s) submitted: G–99D.
Type of request: Extension without
change of a currently approved
collection.
Affected public: Individuals or
households.
Abstract: Under Section 12(a) of the
Railroad Retirement Act, the RRB is
authorized to select, make payments to,
and conduct transactions with an
annuitant’s relative or some other
person willing to act on behalf of the
annuitant as a representative payee. The
collection obtains information needed to
verify the parent-for-child payee still
retains custody of the child.
Changes proposed: The RRB proposes
no changes to Form G–99D.
The burden estimate for the ICR is as
follows:
Annual
responses
Time
(minutes)
Burden
(hours)
G–99D ..........................................................................................................................................
mstockstill on DSK30JT082PROD with NOTICES
Form No.
800
5
67
3. Title and purpose of information
collection: Statement Regarding
Contributions and Support of Children;
OMB 3220–0195.
Section 2(d)(4) of the Railroad
Retirement Act (RRA), provides, in part,
that a child is deemed dependent if the
conditions set forth in Section 202(d)(3),
(4) and (9) of the Social Security Act are
met. Section 202(d)(4) of the Social
Security Act, as amended by Public Law
VerDate Sep<11>2014
18:33 Jun 26, 2017
Jkt 241001
104–121, requires as a condition of
dependency, that a child receives onehalf of his or her support from the
stepparent. This dependency impacts
upon the entitlement of a spouse or
survivor of an employee whose
entitlement is based upon having a
stepchild of the employee in care, or on
an individual seeking a child’s annuity
as a stepchild of an employee.
Therefore, depending on the employee
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Frm 00103
Fmt 4703
Sfmt 4703
for at least one-half support is a
condition affecting eligibility for
increasing an employee or spouse
annuity under the social security overall
minimum provisions on the basis of the
presence of a dependent child, the
employee’s natural child in limited
situations, adopted children,
stepchildren, grandchildren, stepgrandchildren and equitably adopted
children. The regulations outlining
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27JNN1
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Federal Register / Vol. 82, No. 122 / Tuesday, June 27, 2017 / Notices
child support and dependency
requirements are prescribed in 20 CFR
222.50–57.
In order to correctly determine if an
applicant is entitled to a child’s annuity
based on actual dependency, the RRB
uses Form G–139, Statement Regarding
Contributions and Support of Children,
to obtain financial information needed
to make a comparison between the
amount of support received from the
railroad employee and the amount
received from other sources. Completion
is required to obtain a benefit. One
response is required of each respondent.
Previous Requests for Comments: The
RRB has already published the initial
60-day notice (82 FR 17298 on April 10,
2017) required by 44 U.S.C. 3506(c)(2).
That request elicited no comments.
Information Collection Request (ICR)
Title: Statement Regarding
Contributions and Support of Children.
OMB Control Number: 3220–0195.
Form(s) submitted: G–139.
Type of request: Extension without
change of a currently approved
collection.
Affected public: Individuals or
Households.
Abstract: Dependency on the
employee for at least one-half support is
a condition affecting eligibility for
increasing an employee or spouse
annuity under the social security overall
minimum provisions on the basis of the
presence of a dependent child, the
employee’s natural child in limited
situations, adopted children,
stepchildren, grandchildren and stepgrandchildren. The information
collected solicits financial information
needed to determine entitlement to a
child’s annuity based on actual
dependency.
Changes proposed: The RRB proposes
no changes to Form G–139.
The burden estimate for the ICR is as
follows:
Form No.
Annual
responses
Time
(minutes)
Burden
(hours)
G–139 ..........................................................................................................................................
500
60
500
Additional Information or Comments:
Copies of the forms and supporting
documents can be obtained from Dana
Hickman at (312) 751–4981 or
Dana.Hickman@RRB.GOV.
Comments regarding the information
collection should be addressed to Brian
Foster, Railroad Retirement Board, 844
North Rush Street, Chicago, Illinois
60611–1275 or Brian.Foster@rrb.gov and
to the OMB Desk Officer for the RRB,
Fax: 202–395–6974, Email address:
OIRA_Submission@omb.eop.gov.
Brian D. Foster,
Clearance Officer.
[FR Doc. 2017–13370 Filed 6–26–17; 8:45 am]
BILLING CODE 7905–01–P
SECURITIES AND EXCHANGE
COMMISSION
Submission for OMB Review;
Comment Request
Upon Written Request, Copies Available
From: Securities and Exchange
Commission, Office of FOIA Services,
100 F Street NE., Washington, DC
20549–2736.
mstockstill on DSK30JT082PROD with NOTICES
Extension:
Rule 17Ac3–1(a) and Form TA–W; SEC
File No. 270–96 OMB Control No. 3235–
0151.
Notice is hereby given that, pursuant
to the Paperwork Reduction Act of 1995
(‘‘PRA’’) (44 U.S.C. 3501 et seq.), the
Securities and Exchange Commission
(‘‘Commission’’) has submitted to the
Office of Management and Budget
(‘‘OMB’’) a request for approval of
extension of the previously approved
collection of information provided for in
Rule 17Ac3–1(a) (17 CFR 240.17Ac3–
VerDate Sep<11>2014
18:33 Jun 26, 2017
Jkt 241001
1(a)) and Form TA–W (17 CFR
249b.101), under the Securities
Exchange Act of 1934 (15 U.S.C. 78a et
seq.).
Section 17A(c)(4)(B) of the Securities
Exchange Act of 1934 authorizes
transfer agents registered with an
appropriate regulatory agency (‘‘ARA’’)
to withdraw from registration by filing
with the ARA a written notice of
withdrawal and by agreeing to such
terms and conditions as the ARA deems
necessary or appropriate in the public
interest, for the protection of investors,
or in the furtherance of the purposes of
Section 17A.
In order to implement Section
17A(c)(4)(B) of the Exchange Act, the
Commission promulgated Rule 17Ac3–
1(a) and accompanying Form TA–W on
September 1, 1977. Rule 17Ac3–1(a)
provides that notice of withdrawal of
registration as a transfer agent with the
Commission shall be filed on Form TA–
W. Form TA–W requires the
withdrawing transfer agent to provide
the Commission with certain
information, including: (1) The
locations where transfer agent activities
are or were performed; (2) the reasons
for ceasing the performance of such
activities; (3) disclosure of unsatisfied
judgments or liens; and (4) information
regarding successor transfer agents.
The Commission uses the information
disclosed on Form TA–W to determine
whether the registered transfer agent
applying for withdrawal from
registration as a transfer agent should be
allowed to deregister and, if so, whether
the Commission should attach to the
granting of the application any terms or
conditions necessary or appropriate in
the public interest, for the protection of
investors, or in furtherance of the
PO 00000
Frm 00104
Fmt 4703
Sfmt 4703
purposes of Section 17A of the
Exchange Act. Without Rule 17Ac3–1(a)
and Form TA–W, transfer agents
registered with the Commission would
not have a means to voluntarily
deregister it is necessary or appropriate
to do so.
On average, respondents have filed
approximately 17 TA–Ws with the
Commission annually from 2014 to
2017. A Form TA–W filing occurs only
once, when a transfer agent is seeking
deregistration. Approximately 80
percent of Form TA–Ws are completed
by the transfer agent or its employees
and approximately 20 percent of Form
TA–Ws are completed by an outside
filing agent that is hired by the
registrant to prepare the form and file it
electronically. In view of the readilyavailable information requested by Form
TA–W, its short and simple
presentation, and the Commission’s
experience with the filers, we estimate
that approximately 30 minutes is
required to complete and file Form TA–
W. For transfer agents that complete
Form TA–W themselves, we estimate
the internal labor cost of compliance per
filing is $25 (0.5 hours × $50 average
hourly rate for clerical staff time). We
estimate that outside filing agents
charge $100 to complete and file at TA–
W on behalf of a registrant, reflecting an
external labor cost to respondents. The
total annual time burden to the transfer
agent industry is approximately 9 hours
(17 filings × 0.5 hours). The total annual
external labor cost to respondents is
$340 (17 annual forms × $100 × 20%).
An agency may not conduct or
sponsor, and a person is not required to
respond to, a collection of information
under the PRA unless it displays a
currently valid OMB control number.
E:\FR\FM\27JNN1.SGM
27JNN1
]]>Agencies
[Federal Register Volume 82, Number 122 (Tuesday, June 27, 2017)]
[Notices]
[Pages 29123-29125]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-13370]
-----------------------------------------------------------------------
RAILROAD RETIREMENT BOARD
Agency Forms Submitted for OMB Review, Request for Comments
In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C.
Chapter 35), the Railroad Retirement Board (RRB) is forwarding an
Information Collection Request (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
[[Page 29124]]
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: Financial
Disclosure Statement; OMB 3220-0127.
Under Section 10 of the Railroad Retirement Act and Section 2(d) of
the Railroad Unemployment Insurance Act, the RRB may recover
overpayments of annuities, pensions, death benefits, unemployment
benefits, and sickness benefits that were made erroneously. An
overpayment may be waived if the beneficiary was not at fault in
causing the overpayment and recovery would cause financial hardship.
The regulations for the recovery and waiver of erroneous payments are
contained in 20 CFR 255 and CFR 340.
The RRB utilizes Form DR-423, Financial Disclosure Statement, to
obtain information about the overpaid beneficiary's income, debts, and
expenses if that person indicates that (s)he cannot make restitution
for the overpayment. The information is used to determine if the
overpayment should be waived as wholly or partially uncollectible. If
waiver is denied, the information is used to determine the size and
frequency of installment payments. The beneficiary is made aware of the
overpayment by letter and is offered a variety of methods for recovery.
One response is requested of each respondent. Completion is voluntary.
However, failure to provide the requested information may result in a
denial of the waiver request.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (82 FR 17298 on April 10, 2017) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.
Information Collection Request (ICR)
Title: Financial Disclosure Statement.
OMB Control Number: 3220-0127.
Form(s) submitted: DR-423.
Type of request: Extension without change of a currently approved
collection.
Affected public: Individuals or Households.
Abstract: Under the Railroad Retirement and the Railroad
Unemployment Insurance Acts, the Railroad Retirement Board has
authority to secure from an overpaid beneficiary a statement of the
individual's assets and liabilities if waiver of the overpayment is
requested.
Changes proposed: The RRB proposes no changes to Form DR-423.
The burden estimate for the ICR is as follows:
----------------------------------------------------------------------------------------------------------------
Annual
Form No. responses Time (minutes) Burden (hours)
----------------------------------------------------------------------------------------------------------------
DR-423....................................................... 1,200 85 1,700
----------------------------------------------------------------------------------------------------------------
2. Title and purpose of information collection: Representative
Payee Parental Custody Monitoring; OMB 3220-0176.
Under Section 12(a) of the Railroad Retirement Act (RRA), the
Railroad Retirement Board (RRB) is authorized to select, make payments
to, and to conduct transactions with, a beneficiary's relative or some
other person willing to act on behalf of the beneficiary as a
representative payee. The RRB is responsible for determining if direct
payment to the beneficiary or payment to a representative payee would
best serve the beneficiary's interest. Inherent in the RRB's
authorization to select a representative payee is the responsibility to
monitor the payee to assure that the beneficiary's interests are
protected. The RRB utilizes Form G-99D, Parental Custody Report, to
obtain information needed to verify that a parent-for-child
representative payee still has custody of the child. One response is
required from each respondent.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (82 FR 17298 on April 10, 2017) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.
Information Collection Request (ICR)
Title: Representative Payee Parental Custody Monitoring.
OMB Control Number: 3220-0176.
Form(s) submitted: G-99D.
Type of request: Extension without change of a currently approved
collection.
Affected public: Individuals or households.
Abstract: Under Section 12(a) of the Railroad Retirement Act, the
RRB is authorized to select, make payments to, and conduct transactions
with an annuitant's relative or some other person willing to act on
behalf of the annuitant as a representative payee. The collection
obtains information needed to verify the parent-for-child payee still
retains custody of the child.
Changes proposed: The RRB proposes no changes to Form G-99D.
The burden estimate for the ICR is as follows:
----------------------------------------------------------------------------------------------------------------
Annual
Form No. responses Time (minutes) Burden (hours)
----------------------------------------------------------------------------------------------------------------
G-99D........................................................ 800 5 67
----------------------------------------------------------------------------------------------------------------
3. Title and purpose of information collection: Statement Regarding
Contributions and Support of Children; OMB 3220-0195.
Section 2(d)(4) of the Railroad Retirement Act (RRA), provides, in
part, that a child is deemed dependent if the conditions set forth in
Section 202(d)(3), (4) and (9) of the Social Security Act are met.
Section 202(d)(4) of the Social Security Act, as amended by Public Law
104-121, requires as a condition of dependency, that a child receives
one-half of his or her support from the stepparent. This dependency
impacts upon the entitlement of a spouse or survivor of an employee
whose entitlement is based upon having a stepchild of the employee in
care, or on an individual seeking a child's annuity as a stepchild of
an employee. Therefore, depending on the employee for at least one-half
support is a condition affecting eligibility for increasing an employee
or spouse annuity under the social security overall minimum provisions
on the basis of the presence of a dependent child, the employee's
natural child in limited situations, adopted children, stepchildren,
grandchildren, step-grandchildren and equitably adopted children. The
regulations outlining
[[Page 29125]]
child support and dependency requirements are prescribed in 20 CFR
222.50-57.
In order to correctly determine if an applicant is entitled to a
child's annuity based on actual dependency, the RRB uses Form G-139,
Statement Regarding Contributions and Support of Children, to obtain
financial information needed to make a comparison between the amount of
support received from the railroad employee and the amount received
from other sources. Completion is required to obtain a benefit. One
response is required of each respondent.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (82 FR 17298 on April 10, 2017) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.
Information Collection Request (ICR)
Title: Statement Regarding Contributions and Support of Children.
OMB Control Number: 3220-0195.
Form(s) submitted: G-139.
Type of request: Extension without change of a currently approved
collection.
Affected public: Individuals or Households.
Abstract: Dependency on the employee for at least one-half support
is a condition affecting eligibility for increasing an employee or
spouse annuity under the social security overall minimum provisions on
the basis of the presence of a dependent child, the employee's natural
child in limited situations, adopted children, stepchildren,
grandchildren and step-grandchildren. The information collected
solicits financial information needed to determine entitlement to a
child's annuity based on actual dependency.
Changes proposed: The RRB proposes no changes to Form G-139.
The burden estimate for the ICR is as follows:
----------------------------------------------------------------------------------------------------------------
Annual
Form No. responses Time (minutes) Burden (hours)
----------------------------------------------------------------------------------------------------------------
G-139........................................................ 500 60 500
----------------------------------------------------------------------------------------------------------------
Additional Information or Comments: Copies of the forms and
supporting documents can be obtained from Dana Hickman at (312) 751-
4981 or Dana.Hickman@RRB.GOV.
Comments regarding the information collection should be addressed
to Brian Foster, Railroad Retirement Board, 844 North Rush Street,
Chicago, Illinois 60611-1275 or Brian.Foster@rrb.gov and to the OMB
Desk Officer for the RRB, Fax: 202-395-6974, Email address:
OIRA_Submission@omb.eop.gov.
Brian D. Foster,
Clearance Officer.
[FR Doc. 2017-13370 Filed 6-26-17; 8:45 am]
BILLING CODE 7905-01-P
