Agency Forms Submitted for OMB Review, Request for Comments, 3289-3291 [2012-1186]

Download as PDF TKELLEY on DSK3SPTVN1PROD with NOTICES Federal Register / Vol. 77, No. 14 / Monday, January 23, 2012 / Notices within 30 days after all necessary regulatory approvals have been received. The contract will remain in effect until June 30, 2014. Id. Attachment 1 at 5. It may, however, be terminated by either party on not less than 30 days’ written notice. Id. In support of its Notice, the Postal Service filed four attachments as follows: • Attachment 1—a redacted copy of the contract and applicable annexes; • Attachment 2—a certified statement required by 39 CFR 3015.5(c)(2); • Attachment 3—a redacted copy of Governors’ Decision No. 10–1, which establishes prices and classifications for GREP contracts, a description of applicable GREP contracts, formulas for prices, an analysis of the formulas, and certification of the Governors’ vote; and • Attachment 4—an application for non–public treatment of materials to maintain redacted portions of the contract and supporting documents under seal. The Notice advances reasons why the instant GREP contract fits within the Mail Classification Schedule language for GREP Contracts 1. The Postal Service identifies general contract terms that distinguish the instant contract from the baseline GREP agreement. It states that the instant contract differs from the contract in Docket No. CP2010–36 pertaining to revisions or clarification of terms, e.g., definition of qualifying mail, discounts offered by the reseller, minimum revenue, periodic review of minimum commitment, term, assignment, number of rate groups, and solicitation of reseller’s customers. Id. at 4–6. The Postal Service states that the differences, which include price variations based on updated costing information and volume commitments, do not alter the contract’s functional equivalency. Id. at 4. The Postal Service asserts that ‘‘[b]ecause the agreement incorporates the same cost attributes and methodology, the relevant characteristics of this GREP contract are similar, if not the same, as the relevant characteristics of the contract filed in Docket No. CP2010–36.’’ Id. at 4–5. The Postal Service concludes that its filing demonstrates that the new GREP contract complies with the requirements of 39 U.S.C. 3633 and is functionally equivalent to the baseline GREP contract. It states that the differences do not affect the services being offered or the fundamental structure of the contract. Therefore, it requests that the instant contract be included within the GREP Contracts 1 product. Id. at 5–6. VerDate Mar<15>2010 17:58 Jan 20, 2012 Jkt 226001 II. Notice of Filing The Commission establishes Docket No. CP2012–14 for consideration of matters related to the contract identified in the Postal Service’s Notice. Interested persons may submit comments on whether the Postal Service’s contract is consistent with the policies of 39 U.S.C. 3632, 3633, or 3642. Comments are due no later than January 23, 2012. The public portions of this filing can be accessed via the Commission’s Web site, https:// www.prc.gov. The Commission appoints James F. Callow to serve as Public Representative in the captioned proceeding. III. Ordering Paragraphs It is ordered: 1. The Commission establishes Docket No. CP2012–14 for consideration of matters raised by the Postal Service’s Notice. 2. Comments by interested persons in this proceeding are due no later than January 23, 2012. 3. Pursuant to 39 U.S.C. 505, James F. Callow is appointed to serve as the officer of the Commission (Public Representative) to represent the interests of the general public in this proceeding. 4. The Secretary shall arrange for publication of this order in the Federal Register. By the Commission. Shoshana M. Grove, Secretary. [FR Doc. 2012–1218 Filed 1–20–12; 8:45 am] BILLING CODE ;P POSTAL REGULATORY COMMISSION Sunshine Act; Notice of Meeting Wednesday, February 1, 2012, at 11 a.m. PLACE: Commission Hearing Room, 901 New York Avenue NW., Suite 200, Washington, DC 20268–0001. STATUS: Part of this meeting will be open to the public. The rest of the meeting will be closed to the public. The open session will be audiocast. The audiocast may be accessed via the Commission’s Web site at https:// www.prc.gov. MATTERS TO BE CONSIDERED: The agenda for the Commission’s February 2012 meeting includes the items identified below. TIME AND DATE: Portions Open to the Public 1. Report on legislative activities. 2. Report on public participation. 3. Report on international activities. PO 00000 Frm 00064 Fmt 4703 Sfmt 4703 3289 4. Report on post office appeals. 5. Report on other pending dockets. 6. Report on the activities of the Office of the Secretary. Chairman’s Public Comment Period Portion Closed to the Public 7. Discussion of pending litigation. CONTACT PERSON FOR MORE INFORMATION: Stephen L. Sharfman, General Counsel, Postal Regulatory Commission, 901 New York Avenue NW., Suite 200, Washington, DC 20268–0001, at (202) 789–6820 (for agenda-related inquiries) and Shoshana M. Grove, Secretary of the Commission, at (202) 789–6800 or shoshana.grove@prc.gov (for inquiries related to meeting location, access for handicapped or disabled persons, the audiocast, or similar matters). By the Commission. Dated: January 19, 2012. Shoshana M. Grove, Secretary. [FR Doc. 2012–1396 Filed 1–19–12; 4:15 pm] BILLING CODE 7710–FW–P 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 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 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. 1. Title and Purpose of information collection: Application for Benefits Due but Unpaid at Death; OMB 3220–0055. Under Section 2(g) of the Railroad Unemployment Insurance Act (RUIA), E:\FR\FM\23JAN1.SGM 23JAN1 3290 Federal Register / Vol. 77, No. 14 / Monday, January 23, 2012 / Notices benefits that accrued but were not paid because of the death of the employee shall be paid to the same individual(s) to whom benefits are payable under Section 6(a)(1) of the Railroad Retirement Act. The provisions relating to the payment of such benefits are prescribed in 20 CFR 325.5 and 20 CFR 335.5. The RRB provides Form UI–63 for use in applying for the accrued sickness or unemployment benefits unpaid at the death of the employee and for securing the information needed by the RRB to identify the proper payee. One response is requested of each respondent. Completion is required to obtain a benefit. Previous Requests for Comments: The RRB has already published the initial 60-day notice (76 FR 63960 on October 14, 2011) required by 44 U.S.C. 3506(c)(2). That request elicited no comments. Information Collection Request (ICR) Title: Application for Benefits Due but Unpaid at Death. OMB Control Number: 3220–0055. Form submitted: UI–63. Type of request: Extension without change of a currently approved collection. Affected public: Individuals or Households. Abstract: The collection obtains the information needed by the Railroad Retirement Board to pay benefits accrued under section 2(g) of the Railroad Unemployment Insurance Act, but not paid because of the death of the employee. Changes proposed: The RRB proposes no changes to Form UI–63. The burden estimate for the ICR is as follows: Form No. Annual responses Time (minutes) Burden (hours) UI–63 ............................................................................................................................... 25 7 3 2. Title and Purpose of information collection: Medicare; OMB 3220–0082. Under Section 7(d) of the Railroad Retirement Act (RRA), the Railroad Retirement Board (RRB) administers the Medicare program for persons covered by the railroad retirement system. The RRB uses Form AA–6, Employee Application for Medicare; Form AA–7, Spouse/Divorced Spouse Application for Medicare; and Form AA–8, Widow/ Widower Application for Medicare; to obtain the information needed to determine whether individuals who have not yet filed for benefits under the RRA are qualified for Medicare payments provided under Title XVIII of the Social Security Act. Further, in order to determine if a qualified railroad retirement beneficiary who is claiming supplementary medical insurance coverage under Medicare is entitled to a Special Enrollment Period (SEP) and/or premium surcharge relief because of coverage under an Employer Group Health Plan (EGHP), the RRB needs to obtain information regarding the claimant’s EGHP coverage, if any. The RRB uses Form RL–311–F, Evidence of Coverage Under An Employer Group Health Plan, to obtain the basic information needed by the RRB to establish EGHP coverage for a qualified railroad retirement beneficiary. Completion of the forms is required to obtain a benefit. One response is requested of each respondent. Previous Requests for Comments: The RRB has already published the initial 60-day notice (76 FR 63960 on October 14, 2011) required by 44 U.S.C. 3506(c)(2). That request elicited no comments. Information Collection Request (ICR) Title: Medicare. OMB Control Number: 3220–0082. Forms submitted: AA–6, AA–7, AA–8, RL–311–F. Type of request: Extension without change of a currently approved collection. Affected public: Individuals or Households; Business-or-other for profit. Abstract: The Railroad Retirement Board administers the Medicare program for persons covered by the railroad retirement system. The forms in the collection obtain both information needed to enroll non-retired employees and survivor applicants in the plan and information from railroad employers needed to determine if a railroad retirement beneficiary is entitled to a special enrollment period when applying for supplemental medical coverage under Medicare. Changes proposed: The RRB proposes no changes to Forms AA–6, AA–7, AA–8 or RL–311–F. The burden estimate for the ICR is as follows: Annual responses Form No. Time (minutes) Burden (hours) 180 50 10 800 8 8 8 10 24 7 1 133 Total .......................................................................................................................... TKELLEY on DSK3SPTVN1PROD with NOTICES AA–6 ................................................................................................................................ AA–7 ................................................................................................................................ AA–8 ................................................................................................................................ RL–311–F ........................................................................................................................ 1,040 ............................ 165 3. Title and Purpose of information collection: Request to Non-Railroad Employer for Information About Annuitant’s Work and Earnings; OMB 3220–0107. Under Section 2 of the Railroad Retirement Act (RRA), a railroad employee’s retirement annuity or an annuity paid to the spouse of a railroad VerDate Mar<15>2010 17:58 Jan 20, 2012 Jkt 226001 employee is subject to work deductions in the Tier II component of the annuity and any employee supplemental annuity for any month in which the annuitant works for a Last PreRetirement Non-Railroad Employer (LPE). The LPE is defined as the last person, company, or institution, other than a railroad employer, that employed PO 00000 Frm 00065 Fmt 4703 Sfmt 4703 an employee or spouse annuitant. In addition, the employee, spouse, or divorced spouse Tier I annuity benefit is subject to work deductions under Section 2(f)(1) of the RRA for earnings from any non-railroad employer that are over the annual exempt amount. The regulations pertaining to non-payment of annuities by reason of work and LPE E:\FR\FM\23JAN1.SGM 23JAN1 3291 Federal Register / Vol. 77, No. 14 / Monday, January 23, 2012 / Notices are contained in 20 CFR 230.1 and 230.2. The RRB utilizes Form RL–231–F, Request to Non-Railroad Employer for Information About Annuitant’s Work and Earnings, to obtain the information needed to determine if a work deduction should be applied because an annuitant worked in non-railroad employment after the annuity beginning date. One response is requested of each respondent. Completion is voluntary. Previous Requests for Comments: The RRB has already published the initial 60-day notice (76 FR 65219 on October 20, 2011) required by 44 U.S.C. 3506(c)(2). That request elicited no comments. Information Collection Request (ICR) Title: Request to Non-Railroad Employer for Information About Annuitant’s Work and Earnings. OMB Control Number: 3220–0107. Forms submitted: RL–231–F. Type of request: Extension without change of a currently approved collection. Affected public: Private Sector; Businesses or other for-profits. Annual responses Form No. RL–231–F ........................................................................................................................ Additional Information or Comments: Copies of the forms and supporting documents can be obtained from Charles Mierzwa, the agency clearance officer (312) 751–3363 or (Charles.Mierzwa@RRB.GOV). Comments regarding the information collection should be addressed to Charles Mierzwa, Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois, 60611–2092 or Charles.Mierzwa@RRB.GOV and to the OMB Desk Officer for the RRB, Fax: (202) 395–6974, Email address: OIRA_Submission@omb.eop.gov. Charles Mierzwa, Clearance Officer. [FR Doc. 2012–1186 Filed 1–20–12; 8:45 am] BILLING CODE 7905–01–P SECURITIES AND EXCHANGE COMMISSION Proposed Collection; Comment Request Upon Written Request, Copies Available From: Securities and Exchange Commission, Office of Investor Education and Advocacy, Washington, DC 20549. TKELLEY on DSK3SPTVN1PROD with NOTICES Extension: Rule 17Ac2–2 and Form TA–2, SEC File No. 270–298, OMB Control No. 3235– 0337. Notice is hereby given that pursuant to the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.), the Securities and Exchange Commission (‘‘Commission’’) is soliciting comments on the existing collection of information provided for in Rule 17Ac2–2 (17 CFR 240.17Ac2–2) and Form TA–2 under the Securities Exchange Act of 1934 (15 U.S.C. 78a et seq.) (‘‘Exchange Act’’). VerDate Mar<15>2010 17:58 Jan 20, 2012 Jkt 226001 Abstract: Under the Railroad Retirement Act (RRA), benefits are not payable if an annuitant works for an employer covered under the RRA or last non-railroad employer. The collection obtains information regarding an annuitant’s work and earnings from a non-railroad employer. The information is used for determining whether benefits should be withheld. Changes proposed: The RRB proposes no changes to Form RL–231–F. The burden estimate for the ICR is as follows: Rule 17Ac2–2 and Form TA–2 require transfer agents to file an annual report of their business activities with the Commission. These reporting requirements are designed to ensure that all registered transfer agents are providing the Commission with sufficient information on an annual basis about the transfer agent community and for the Commission to effectively monitor business activities of transfer agents. The amount of time needed to comply with the requirements of amended Rule 17Ac2–2 and Form TA–2 varies. From the total 473 registered transfer agents, approximately 30 registrants would be required to complete only Questions 1 through 4 and the signature section of amended Form TA–2, which the Commission estimates would take each registrant about 30 minutes, for a total burden of 15 hours (30 × .5 hours). Approximately 111 registrants would be required to answer Questions 1 through 5, 10, and 11 and the signature section, which the Commission estimates would take about 1 hour and 30 minutes, for a total of 166.5 hours (111 × 1.5 hours). The remaining registrants, approximately 332, would be required to complete the entire Form TA–2, which the Commission estimates would take about 6 hours, for a total of 1,992 hours (332 × 6 hours). The aggregate annual burden on all 473 transfer agents registered with the Commission as of January 1, 2012, is thus approximately 2,174 hours (15 hours + 166.5 hours + 1,992 hours). We estimate that the total cost of reviewing and entering the information reported on the Forms TA–2 for respondents is $41.50 per hour. The Commission estimates that the total internal labor cost of complying with the rule and form requirements would PO 00000 Frm 00066 Fmt 4703 Sfmt 9990 Time (minutes) 300 Burden (hours) 30 150 be $90,221 annually ($41.50 × 2,174). This, however, is solely a monetization of the hour burden and is not a separate cost burden. Written comments are invited on: (a) Whether the proposed collection of information is necessary for the proper performance of the functions of the Commission, including whether the information shall have practical utility; (b) the accuracy of the Commission’s estimates of the burden of the proposed collection of information; (c) ways to enhance the quality, utility, and clarity of the information on respondents; and (d) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or other forms of information technology. Consideration will be given to comments and suggestions submitted in writing within 60 days of this publication. The Commission may not conduct or sponsor a collection of information unless it displays a currently valid Office of Management and Budget (‘‘OMB’’) control number. No person shall be subject to any penalty for failing to comply with a collection of information subject to the PRA that does not display a valid OMB control number. Please direct your written comments to: Thomas Bayer, Director/Chief Information Officer, Securities and Exchange Commission, c/o Remi PavlikSimon, 6432 General Green Way, Alexandria, Virginia 22312 or send an email to: PRA_Mailbox@sec.gov. Dated: January 17, 2012. Kevin M. O’Neill, Deputy Secretary. [FR Doc. 2012–1167 Filed 1–20–12; 8:45 am] BILLING CODE 8011–01–P E:\FR\FM\23JAN1.SGM 23JAN1

Agencies

[Federal Register Volume 77, Number 14 (Monday, January 23, 2012)]
[Notices]
[Pages 3289-3291]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-1186]


=======================================================================
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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 
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 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.
    1. Title and Purpose of information collection: Application for 
Benefits Due but Unpaid at Death; OMB 3220-0055.
    Under Section 2(g) of the Railroad Unemployment Insurance Act 
(RUIA),

[[Page 3290]]

benefits that accrued but were not paid because of the death of the 
employee shall be paid to the same individual(s) to whom benefits are 
payable under Section 6(a)(1) of the Railroad Retirement Act. The 
provisions relating to the payment of such benefits are prescribed in 
20 CFR 325.5 and 20 CFR 335.5.
    The RRB provides Form UI-63 for use in applying for the accrued 
sickness or unemployment benefits unpaid at the death of the employee 
and for securing the information needed by the RRB to identify the 
proper payee. One response is requested of each respondent. Completion 
is required to obtain a benefit.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (76 FR 63960 on October 14, 2011) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Application for Benefits Due but Unpaid at Death.
    OMB Control Number: 3220-0055.
    Form submitted: UI-63.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or Households.
    Abstract: The collection obtains the information needed by the 
Railroad Retirement Board to pay benefits accrued under section 2(g) of 
the Railroad Unemployment Insurance Act, but not paid because of the 
death of the employee.
    Changes proposed: The RRB proposes no changes to Form UI-63.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                        Form No.                         Annual  responses   Time  (minutes)    Burden  (hours)
----------------------------------------------------------------------------------------------------------------
UI-63..................................................                25                  7                  3
----------------------------------------------------------------------------------------------------------------

    2. Title and Purpose of information collection: Medicare; OMB 3220-
0082.
    Under Section 7(d) of the Railroad Retirement Act (RRA), the 
Railroad Retirement Board (RRB) administers the Medicare program for 
persons covered by the railroad retirement system. The RRB uses Form 
AA-6, Employee Application for Medicare; Form AA-7, Spouse/Divorced 
Spouse Application for Medicare; and Form AA-8, Widow/Widower 
Application for Medicare; to obtain the information needed to determine 
whether individuals who have not yet filed for benefits under the RRA 
are qualified for Medicare payments provided under Title XVIII of the 
Social Security Act.
    Further, in order to determine if a qualified railroad retirement 
beneficiary who is claiming supplementary medical insurance coverage 
under Medicare is entitled to a Special Enrollment Period (SEP) and/or 
premium surcharge relief because of coverage under an Employer Group 
Health Plan (EGHP), the RRB needs to obtain information regarding the 
claimant's EGHP coverage, if any. The RRB uses Form RL-311-F, Evidence 
of Coverage Under An Employer Group Health Plan, to obtain the basic 
information needed by the RRB to establish EGHP coverage for a 
qualified railroad retirement beneficiary. Completion of the forms is 
required to obtain a benefit. One response is requested of each 
respondent.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (76 FR 63960 on October 14, 2011) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Medicare.
    OMB Control Number: 3220-0082.
    Forms submitted: AA-6, AA-7, AA-8, RL-311-F.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or Households; Business-or-other for 
profit.
    Abstract: The Railroad Retirement Board administers the Medicare 
program for persons covered by the railroad retirement system. The 
forms in the collection obtain both information needed to enroll non-
retired employees and survivor applicants in the plan and information 
from railroad employers needed to determine if a railroad retirement 
beneficiary is entitled to a special enrollment period when applying 
for supplemental medical coverage under Medicare.
    Changes proposed: The RRB proposes no changes to Forms AA-6, AA-7, 
AA-8 or RL-311-F.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                 Annual
                         Form No.                               responses      Time  (minutes)   Burden  (hours)
----------------------------------------------------------------------------------------------------------------
AA-6......................................................               180                 8                24
AA-7......................................................                50                 8                 7
AA-8......................................................                10                 8                 1
RL-311-F..................................................               800                10               133
                                                           -----------------------------------------------------
    Total.................................................             1,040  ................               165
----------------------------------------------------------------------------------------------------------------

    3. Title and Purpose of information collection: Request to Non-
Railroad Employer for Information About Annuitant's Work and Earnings; 
OMB 3220-0107.
    Under Section 2 of the Railroad Retirement Act (RRA), a railroad 
employee's retirement annuity or an annuity paid to the spouse of a 
railroad employee is subject to work deductions in the Tier II 
component of the annuity and any employee supplemental annuity for any 
month in which the annuitant works for a Last Pre-Retirement Non-
Railroad Employer (LPE). The LPE is defined as the last person, 
company, or institution, other than a railroad employer, that employed 
an employee or spouse annuitant. In addition, the employee, spouse, or 
divorced spouse Tier I annuity benefit is subject to work deductions 
under Section 2(f)(1) of the RRA for earnings from any non-railroad 
employer that are over the annual exempt amount. The regulations 
pertaining to non-payment of annuities by reason of work and LPE

[[Page 3291]]

are contained in 20 CFR 230.1 and 230.2.
    The RRB utilizes Form RL-231-F, Request to Non-Railroad Employer 
for Information About Annuitant's Work and Earnings, to obtain the 
information needed to determine if a work deduction should be applied 
because an annuitant worked in non-railroad employment after the 
annuity beginning date. One response is requested of each respondent. 
Completion is voluntary.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (76 FR 65219 on October 20, 2011) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Request to Non-Railroad Employer for Information About 
Annuitant's Work and Earnings.
    OMB Control Number: 3220-0107.
    Forms submitted: RL-231-F.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Private Sector; Businesses or other for-profits.
    Abstract: Under the Railroad Retirement Act (RRA), benefits are not 
payable if an annuitant works for an employer covered under the RRA or 
last non-railroad employer. The collection obtains information 
regarding an annuitant's work and earnings from a non-railroad 
employer. The information is used for determining whether benefits 
should be withheld.
    Changes proposed: The RRB proposes no changes to Form RL-231-F.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                 Annual
                         Form No.                               responses      Time  (minutes)   Burden  (hours)
----------------------------------------------------------------------------------------------------------------
RL-231-F..................................................               300                30               150
----------------------------------------------------------------------------------------------------------------

    Additional Information or Comments: Copies of the forms and 
supporting documents can be obtained from Charles Mierzwa, the agency 
clearance officer (312) 751-3363 or (Charles.Mierzwa@RRB.GOV).
    Comments regarding the information collection should be addressed 
to Charles Mierzwa, Railroad Retirement Board, 844 North Rush Street, 
Chicago, Illinois, 60611-2092 or Charles.Mierzwa@RRB.GOV and to the OMB 
Desk Officer for the RRB, Fax: (202) 395-6974, Email address: OIRA_Submission@omb.eop.gov.

Charles Mierzwa,
Clearance Officer.
[FR Doc. 2012-1186 Filed 1-20-12; 8:45 am]
BILLING CODE 7905-01-P
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