Agency Forms Submitted for OMB Review, Request for Comments, 66877-66880 [2012-27114]

Download as PDF Federal Register / Vol. 77, No. 216 / Wednesday, November 7, 2012 / Notices Multiplying 1.37262300 by $100 million yields $137,262,300. Multiplying $50 million by 1.37262300 produces $68,631,150. The Account balance on June 30, 2012, was $184,918,694.78. Accordingly, the surcharge rate for calendar year 2013 is zero. pmangrum on DSK3VPTVN1PROD with NOTICES Monthly Compensation Base For years after 1988, section 1(i) of the Act contains a formula for determining the monthly compensation base. Under the prescribed formula, the monthly compensation base increases by approximately two-thirds of the cumulative growth in average national wages since 1984. The monthly compensation base for months in calendar year 2013 shall be equal to the greater of (a) $600 or (b) $600 [1 + {(A ¥ 37,800)/56,700}], where A equals the amount of the applicable base with respect to tier 1 taxes for 2013 under section 3231(e)(2) of the Internal Revenue Code of 1986. Section 1(i) further provides that if the amount so determined is not a multiple of $5, it shall be rounded to the nearest multiple of $5. The calendar year 2013 tier 1 tax base is $113,700. Subtracting $37,800 from $113,700 produces $75,900. Dividing $75,900 by $56,700 yields a ratio of 1.33862434. Adding one gives 2.33862434. Multiplying $600 by the amount 2.33862434 produces the amount of $1,403.17, which must then be rounded to $1,405. Accordingly, the monthly compensation base is determined to be $1,405 for months in calendar year 2013. Amounts Related to Changes in Monthly Compensation Base For years after 1988, sections 1(k), 3, 4(a–2)(i)(A) and 2(c) of the Act contain formulas for determining amounts related to the monthly compensation base. Under section 1(k), remuneration earned from employment covered under the Act cannot be considered subsidiary remuneration if the employee’s base year compensation is less than 2.5 times the monthly compensation base for months in such base year. Under section 3, an employee shall be a ‘‘qualified employee’’ if his/her base year compensation is not less than 2.5 times the monthly compensation base for months in such base year. Under section 4(a–2)(i)(A), an employee who leaves work voluntarily without good cause is disqualified from receiving unemployment benefits until he has been paid compensation of not less than 2.5 times the monthly compensation base for months in the calendar year in which the disqualification ends. VerDate Mar<15>2010 15:43 Nov 06, 2012 Jkt 229001 Multiplying 2.5 by the calendar year 2013 monthly compensation base of $1,405 produces $3,512.50. Accordingly, the amount determined under sections 1(k), 3 and 4(a–2)(i)(A) is $3,512.50 for calendar year 2013. Under section 2(c), the maximum amount of normal benefits paid for days of unemployment within a benefit year and the maximum amount of normal benefits paid for days of sickness within a benefit year shall not exceed an employee’s compensation in the base year. In determining an employee’s base year compensation, any money remuneration in a month not in excess of an amount that bears the same ratio to $775 as the monthly compensation base for that year bears to $600 shall be taken into account. The calendar year 2013 monthly compensation base is $1,405. The ratio of $1,405 to $600 is 2.34166667. Multiplying 2.34166667 by $775 produces $1,815. Accordingly, the amount determined under section 2(c) is $1,815 for months in calendar year 2013. Maximum Daily Benefit Rate Section 2(a)(3) contains a formula for determining the maximum daily benefit rate for registration periods beginning after June 30, 1989, and after each June 30 thereafter. Legislation enacted on October 9, 1996, revised the formula for indexing maximum daily benefit rates. Under the prescribed formula, the maximum daily benefit rate increases by approximately two-thirds of the cumulative growth in average national wages since 1984. The maximum daily benefit rate for registration periods beginning after June 30, 2013, shall be equal to 5 percent of the monthly compensation base for the base year immediately preceding the beginning of the benefit year. Section 2(a)(3) further provides that if the amount so computed is not a multiple of $1, it shall be rounded down to the nearest multiple of $1. The calendar year 2012 monthly compensation base is $1,365. Multiplying $1,365 by 0.05 yields $68.25, which must then be rounded down to $68. Accordingly, the maximum daily benefit rate for days of unemployment and days of sickness beginning in registration periods after June 30, 2013, is determined to be $68. Dated: October 31, 2012. By Authority of the Board. Martha P. Rico, Secretary to the Board. [FR Doc. 2012–27113 Filed 11–6–12; 8:45 am] BILLING CODE 7905–01–P PO 00000 Frm 00085 Fmt 4703 Sfmt 4703 66877 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 three Information Collection Requests (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 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 Employee Annuity Under the Railroad Retirement Act; OMB 3220–0002. Section 2a of the Railroad Retirement Act (RRA) provides for payments of age and service, disability, and supplemental annuities to qualified employees. An annuity cannot be paid until the employee stops working for a railroad employer. In addition, the age and service employee must relinquish any rights held to such a job. A disabled employee does not need to relinquish employee rights until attaining Full Retirement Age, or if earlier, when their spouse files for a spouse annuity. Benefits become payable after the employee meets certain other requirements, which depend on the type of annuity payable. The requirements for obtaining the annuities are prescribed in 20 CFR 216 and 220. To collect the information needed to help determine an applicant’s entitlement to, and the amount of, an employee retirement annuity the RRB uses Forms AA–1, Application for Employee Annuity; AA–1d, Application for Determination of Employee Disability; G–204, Verification of Workers Compensation/Public Disability Benefit Information and electronic Form SUMMARY: E:\FR\FM\07NON1.SGM 07NON1 66878 Federal Register / Vol. 77, No. 216 / Wednesday, November 7, 2012 / Notices AA–1cert, Application Summary and Certification. The AA–1 application process obtains information from an applicant about their marital history, work history, military service, benefits from other governmental agencies, railroad pensions and Medicare entitlement for either an age and service or disability annuity. An RRB representative interviews the applicant either at a field office (preferred), an itinerant point, or by telephone. During the interview, the RRB representative enters the information obtained into an on-line information system. Upon completion of the interview, the on-line information system generates, for the applicant’s review and traditional pen and ink ‘‘wet’’ signature, Form AA–1cert, Application Summary and Certification, which summarizes the information that was provided or verified by the applicant. When the RRB representative is unable to contact the applicant in person or by telephone, for example, the applicant lives in another country, a manual version of Form AA–1 is used. Form AA–1d, Application for Determination of Employee’s Disability, is completed by an employee who is filing for a disability annuity under the RRA, or a disability freeze under the Social Security Act, for early Medicare based on a disability. Form G–204, Verification of Worker’s Compensation/ Public Disability Benefit Information, is used to obtain and verify information concerning a worker’s compensation or a public disability benefit that is or will be paid by a public agency to a disabled railroad employee. Consistent with 20 CFR 217.17, upon completion of the AA–1 interview process, the RRB proposes to provide, in addition to the current Form AA–1cert pen and ink ‘‘wet’’ signature, an alternate signing method called ‘‘Attestation,’’ which will be documented by new Form AA–1sum, Application Summary. Attestation refers to an action taken by the RRB representative to confirm and annotate in the RRB records (1) the applicant’s intent to file an application; (2) the applicant’s affirmation under penalty of perjury that the information provided is correct; and (3) the applicant’s agreement to sign the application by proxy. The information collected as part of the AA–1 interview process will be the same irrespective of whether the application is signed by a pen and ink ‘‘wet’’ signature or by attestation. The only difference will be the method of signature. In addition, consistent with Department of Treasury guidelines, the RRB proposes revisions to Forms AA–1 and AA–1cert to provide claimants a debit card payment option. Other nonburden-impacting editorial and formatting changes are proposed. One response is requested of each respondent. Completion of the forms is required to obtain a benefit. Previous Requests for Comments: The RRB has already published the initial 60-day notice (77 FR 1093 on January 9, 2012) required by 44 U.S.C. 3506(c)(2). That request elicited no comments. Information Collection Request (ICR) Title: Application for Employee Annuity Under the Railroad Retirement Act. OMB Control Number: 3220–0002. Form(s) submitted: AA–1, AA–1cert, AA–1d, AA–1sum and G–204. Type of request: Revision of a currently approved collection. Affected public: Individuals or Households. Abstract: The Railroad Retirement Act provides for payment of age, disability and supplemental annuities to qualified employees. The application and related forms obtain information about the applicant’s family work history, military service, disability benefits from other government agencies and public or private pensions. The information is used to determine entitlement to and the amount of the annuity applied for. Changes proposed: The RRB proposes revisions to Forms AA–1 and AA–1cert to provide claimants with a debit card payment option. The RRB also proposes the creation of Form AA–1sum, Application Summary, which will be produced at the end of the AA–1 interview process for documenting the alternate signing method called ‘‘Attestation.’’ The RRB proposes no revisions to Forms AA–1d or G–204. The burden estimate for the ICR is as follows: Annual responses Form No. Time (minutes) Burden (hours) 100 4,900 3,700 5 9,100 20 62 30 35 60 29 15 103 2,450 2,158 5 4,398 5 Total ...................................................................................................................................... pmangrum on DSK3VPTVN1PROD with NOTICES AA–1 (without assistance) ........................................................................................................... AA–1cert (with assistance) .......................................................................................................... AA–1d (with assistance) .............................................................................................................. AA–1d (without assistance) ......................................................................................................... AA–1sum (with assistance) ......................................................................................................... G–204 .......................................................................................................................................... 17,825 ........................ 9,119 2. Title and purpose of information collection: Application for Survivor Insurance Annuities; OMB 3220–0030. Under Section 2(d) of the Railroad Retirement Act (RRA), monthly survivor annuities are payable to surviving widow(er)s, parents, unmarried children, and in certain cases, divorced spouses, mothers (fathers), remarried widow(er)s, and grandchildren of deceased railroad employees if there are no qualified survivors of the employee immediately eligible for an annuity. The requirements relating to the annuities are prescribed in 20 CFR 216, 217, 218, and 219. VerDate Mar<15>2010 15:43 Nov 06, 2012 Jkt 229001 To collect the information needed to help determine an applicant’s entitlement to, and the amount of, a survivor annuity the RRB uses Forms AA–17, Application for Widow(er)’s Annuity; AA–17b, Applications for Determination of Widow(er)’s Disability; AA–18, Application for Mother’s/ Father’s and Child’s Annuity; AA–19, Application for Child’s Annuity; AA– 19a, Application for Determination of Child’s Disability; AA–20, Application for Parent’s Annuity, and electronic Form AA–17cert, Application Summary and Certification. PO 00000 Frm 00086 Fmt 4703 Sfmt 4703 The AA–17 application process obtains information from an applicant about their marital history, work history, benefits from other government agencies, and Medicare entitlement for a survivor annuity. An RRB representative interviews the applicant either at a field office (preferred), an itinerant point, or by telephone. During the interview, the RRB representative enters the information obtained into an on-line information system. Upon completion of the interview, the system generates, for the applicant’s review and traditional pen and ink ‘‘wet’’ signature, Form AA–17cert, Application Summary E:\FR\FM\07NON1.SGM 07NON1 66879 Federal Register / Vol. 77, No. 216 / Wednesday, November 7, 2012 / Notices and Certification, which is a summary of the information that the applicant provided or verified. When the RRB representative is unable to contact the applicant in person or by telephone, for example, the applicant lives in another country, a manual version of Form AA– 17 is used. Consistent with 20 CFR 217.17, upon completion of the AA–17 interview process, the RRB proposes to provide, in addition to the current Form AA–17cert pen and ink ‘‘wet’’ signature, an alternate signing method called ‘‘Attestation,’’ which will be documented by new Form AA–17sum, Application Summary. Attestation refers to an action taken by the RRB representative to confirm and annotate in the RRB records (1) the applicant’s intent to file an application; (2) the applicant’s affirmation under penalty of perjury that the information provided is correct; and (3) the applicant’s agreement to sign the application by proxy. The information collected as part of the AA–17 interview process will be the same irrespective of whether the application is signed by a pen and ink ‘‘wet’’ signature or by attestation. The only difference will be the method of signature. In addition, consistent with Department of Treasury guidelines, the RRB proposes revisions to Forms AA– 17, AA–17cert, AA–18, AA–19, and AA–20cert to provide claimants a debit card payment option. Other nonburden-impacting editorial and formatting changes are proposed. No changes are proposed to Forms AA–17b and AA–19a. One response is requested of each respondent. Completion of the forms is required to obtain a benefit. Previous Requests for Comments: The RRB has already published the initial 60-day notice (77 FR 1093 on January 9, 2012) required by 44 U.S.C. 3506(c)(2). That request elicited no comments. Information Collection Request (ICR) Title: Application for Survivor Insurance Annuities. OMB Control Number: 3220–0030. Form(s) submitted: AA–17, AA–17b, AA–17cert, AA–17sum, AA–18, AA–19, AA–19a, and AA–20cert. Type of request: Revision of a currently approved collection. Affected public: Individuals or Households. Abstract: Under Section 2(d) of the Railroad Retirement Act, monthly survivor annuities are payable to surviving widow(er)s, parents, unmarried children, and in certain cases, divorced wives (husbands), mothers (fathers), remarried widow(er)s and grandchildren of deceased railroad employees. The collection obtains information needed by the RRB for determining entitlement to and amount of the annuity applied for. Changes proposed: The RRB proposes revisions to Forms AA–17, AA–17cert, AA–18, AA–19, and AA–20cert to provide claimants with a debit card payment option. The RRB also proposes the creation of Form AA–17sum, Application Summary, to be produced at the end of the AA–17 interview process for claimants who choose the alternate signing method called ‘‘Attestation.’’ Other non-burdenimpacting editorial and formatting changes are proposed. No changes are proposed to Forms AA–17b and AA– 19a. The burden estimate for the ICR is as follows: Annual responses Form No. Time (minutes) Burden (hours) 100 280 20 900 2,100 12 9 285 15 1 47 40 50 20 19 47 47 45 65 47 78 187 17 300 665 9 7 214 16 1 Total .................................................................................................................................. pmangrum on DSK3VPTVN1PROD with NOTICES AA–17 (without assistance) ......................................................................................................... AA–17b (with assistance) ............................................................................................................ AA–17b (without assistance) ....................................................................................................... AA–17cert (with assistance) ........................................................................................................ AA–17sum (with assistance) ....................................................................................................... AA–18 (without assistance) ......................................................................................................... AA–19 (without assistance) ......................................................................................................... AA–19a (with assistance) ............................................................................................................ AA–19a (without assistance) ....................................................................................................... AA–20 (without assistance) ......................................................................................................... 3,722 ........................ 1,494 3. Title and purpose of information collection: Application for Spouse Annuity Under the Railroad Retirement Act; OMB 3220–0042. Section 2(c) of the Railroad Retirement Act (RRA), provides for the payment of annuities to spouses of railroad retirement annuitants who meet the requirements under the RRA. The age requirements for a spouse annuity depend on the employee’s age, date of retirement, and years of railroad service. The requirements relating to the annuities are prescribed in 20 CFR 216, 218, 219, 232, 234, and 295. To collect the information needed to help determine an applicant’s entitlement to, and the amount of, a spouse annuity the RRB uses Form AA– 3, Application for Spouse/Divorced Spouse Annuity, and electronic Form VerDate Mar<15>2010 15:43 Nov 06, 2012 Jkt 229001 AA–3cert, Application Summary and Certification. The AA–3 application process gathers information from an applicant about their marital history, work history, benefits from other government agencies, railroad pensions and Medicare entitlement for a spouse annuity. An RRB representative interviews the applicant either at a field office (preferred), an itinerant point, or by telephone. During the interview, the RRB representative enters the information obtained into an on-line information system. Upon completion of the interview, the system generates, for the applicant’s review and traditional pen and ink ‘‘wet’’ signature, Form AA– 3cert, Application Summary and Certification, which is a summary of the information that the applicant provided PO 00000 Frm 00087 Fmt 4703 Sfmt 4703 or verified. When the RRB representative is unable to contact the applicant in person or by telephone, for example, the applicant lives in another country, a manual version of Form AA– 3 is used. Consistent with 20 CFR 217.17, upon completion of the AA–3 interview process, the RRB proposes to provide, in addition to the current Form AA–3cert pen and ink ‘‘wet’’ signature, an alternate signing method called ‘‘Attestation,’’ which will be documented by new form AA–3sum, Application Summary. Attestation refers to an action taken by the RRB representative to confirm and annotate in the RRB records (1) the applicant’s intent to file an application; (2) the applicant’s affirmation under penalty of perjury that the information provided is E:\FR\FM\07NON1.SGM 07NON1 66880 Federal Register / Vol. 77, No. 216 / Wednesday, November 7, 2012 / Notices correct; and (3) the applicant’s agreement to sign the application by proxy. The information collected as part of the AA–3 interview process will be the same irrespective of whether the application is signed by a pen and ink ‘‘wet’’ signature or by attestation. The only difference will be the method of signature. In addition, consistent with Department of Treasury guidelines, the RRB proposes revisions to Forms AA–3 and AA–3cert to provide claimants a debit card payment option. Other nonburden-impacting editorial and formatting changes are proposed. One response is requested of each respondent. Completion of the forms is required to obtain a benefit. Previous Requests for Comments: The RRB has already published the initial 60-day notice (77 FR 1093 on January 9, 2012) required by 44 U.S.C. 3506(c)(2). That request elicited no comments. Information Collection Request (ICR) Title: Application for Spouse Annuity Under the Railroad Retirement Act. OMB Control Number: 3220–0042. Form(s) submitted: AA–3, AA–3cert, and AA–3sum. Type of request: Revision of a currently approved collection. Affected public: Individuals or Households. Abstract: The Railroad Retirement Act provides for the payment of annuities to spouses of railroad retirement annuitants who meet the requirements under the Act. The application obtains information supporting the claim for benefits based on being a spouse of an annuitant. The information is used for determining entitlement to and amount of the annuity applied for. Changes proposed: The RRB proposes revisions to Forms AA–3 and AA–3cert to provide claimants with a debit card payment option. The RRB also proposes the creation of Form AA–3sum, Application Summary, to be produced at the end of the AA–3 interview process for claimants who choose the alternate signing method called ‘‘Attestation.’’ Other non-burdenimpacting editorial and formatting changes are proposed. The burden estimate for the ICR is as follows: Annual responses Form No. Time (minutes) Burden (hours) AA–3 (without assistance) ........................................................................................................... AA–3cert (with assistance) .......................................................................................................... AA–3sum (with assistance) ......................................................................................................... 250 3,700 7,100 58 30 29 242 1,850 3,432 Total ...................................................................................................................................... 11,050 ........................ 5,524 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 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, Chief of Information Resources Management. [FR Doc. 2012–27114 Filed 11–6–12; 8:45 am] BILLING CODE 7905–01–P SECURITIES AND EXCHANGE COMMISSION pmangrum on DSK3VPTVN1PROD with NOTICES Submission for OMB Review; Comment Request Upon Written Request Copies Available From: Securities and Exchange Commission, Office of Investor Education and Advocacy, Washington, DC 20549–0213. Extension: Rule 17f–1(c) and Form X–17F–1A; SEC File No. 270–29, OMB Control No. 3235– 0037. Notice is hereby given that pursuant to the Paperwork Reduction Act of 1995 VerDate Mar<15>2010 15:43 Nov 06, 2012 Jkt 229001 (44 U.S.C. 3501 et seq.) the Securities and Exchange Commission (‘‘Commission’’) has submitted to the Office of Management and Budget a request for approval of extension of the existing collection of information provided for in the following rule: Rule 17f–1(c) (17 CFR 240.17f–1(c) and Form X–17F–1A (17 CFR 249.100) under the Securities Exchange Act of 1934 (15 U.S.C. 78a et seq.) (‘‘Exchange Act’’). Rule 17f–1(c) requires approximately 26,000 entities in the securities industry to report lost, stolen, missing, or counterfeit securities certificates to the Commission or its designee, to a registered transfer agent for the issue, and, when criminal activity is suspected, to the Federal Bureau of Investigation. Such entities are required to use Form X–17F–1A to make such reports. Filing these reports fulfills a statutory requirement that reporting institutions report and inquire about missing, lost, counterfeit, or stolen securities. Since these reports are compiled in a central database, the rule facilitates reporting institutions to access the database that stores information for the Lost and Stolen Securities Program. We estimate that 26,000 reporting institutions will report that securities certificates are either missing, lost, counterfeit, or stolen annually and that each reporting institution will submit this report 50 times each year. The staff estimates that the average amount of PO 00000 Frm 00088 Fmt 4703 Sfmt 4703 time necessary to comply with Rule 17f–1(c) and Form X17F–1A is five minutes per submission. The total burden is 108,333 hours annually for the entire industry (26,000 times 50 times 5 divided by 60). Rule 17f–1(c) is a reporting rule and does not specify a retention period. The rule requires an incident-based reporting requirement by the reporting institutions when securities certificates are discovered to be missing, lost, counterfeit, or stolen. Registering under Rule 17f–1(c) is mandatory to obtain the benefit of a central database that stores information about missing, lost, counterfeit, or stolen securities for the Lost and Stolen Securities Program. Reporting institutions required to register under Rule 17f–1(c) will not be kept confidential; however, the Lost and Stolen Securities Program database will be kept confidential. The Commission may not conduct or sponsor a collection of information unless it displays a currently valid 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 Office of Management and Budget (OMB) control number. Background documentation for this information collection may be viewed at the following Web site: www.reginfo.gov. Comments should be directed to: (i) Desk Officer for the Securities and Exchange Commission, E:\FR\FM\07NON1.SGM 07NON1

Agencies

Railroad Retirement Board

[Federal Register Volume 77, Number 216 (Wednesday, November 7, 2012)]
[Notices]
[Pages 66877-66880]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-27114]

-----------------------------------------------------------------------

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
three Information Collection Requests (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 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
Employee Annuity Under the Railroad Retirement Act; OMB 3220-0002.
Section 2a of the Railroad Retirement Act (RRA) provides for
payments of age and service, disability, and supplemental annuities to
qualified employees. An annuity cannot be paid until the employee stops
working for a railroad employer. In addition, the age and service
employee must relinquish any rights held to such a job. A disabled
employee does not need to relinquish employee rights until attaining
Full Retirement Age, or if earlier, when their spouse files for a
spouse annuity. Benefits become payable after the employee meets
certain other requirements, which depend on the type of annuity
payable. The requirements for obtaining the annuities are prescribed in
20 CFR 216 and 220.
To collect the information needed to help determine an applicant's
entitlement to, and the amount of, an employee retirement annuity the
RRB uses Forms AA-1, Application for Employee Annuity; AA-1d,
Application for Determination of Employee Disability; G-204,
Verification of Workers Compensation/Public Disability Benefit
Information and electronic Form

[[Page 66878]]

AA-1cert, Application Summary and Certification.
The AA-1 application process obtains information from an applicant
about their marital history, work history, military service, benefits
from other governmental agencies, railroad pensions and Medicare
entitlement for either an age and service or disability annuity. An RRB
representative interviews the applicant either at a field office
(preferred), an itinerant point, or by telephone. During the interview,
the RRB representative enters the information obtained into an on-line
information system. Upon completion of the interview, the on-line
information system generates, for the applicant's review and
traditional pen and ink ``wet'' signature, Form AA-1cert, Application
Summary and Certification, which summarizes the information that was
provided or verified by the applicant. When the RRB representative is
unable to contact the applicant in person or by telephone, for example,
the applicant lives in another country, a manual version of Form AA-1
is used.
Form AA-1d, Application for Determination of Employee's Disability,
is completed by an employee who is filing for a disability annuity
under the RRA, or a disability freeze under the Social Security Act,
for early Medicare based on a disability. Form G-204, Verification of
Worker's Compensation/Public Disability Benefit Information, is used to
obtain and verify information concerning a worker's compensation or a
public disability benefit that is or will be paid by a public agency to
a disabled railroad employee.
Consistent with 20 CFR 217.17, upon completion of the AA-1
interview process, the RRB proposes to provide, in addition to the
current Form AA-1cert pen and ink ``wet'' signature, an alternate
signing method called ``Attestation,'' which will be documented by new
Form AA-1sum, Application Summary. Attestation refers to an action
taken by the RRB representative to confirm and annotate in the RRB
records (1) the applicant's intent to file an application; (2) the
applicant's affirmation under penalty of perjury that the information
provided is correct; and (3) the applicant's agreement to sign the
application by proxy. The information collected as part of the AA-1
interview process will be the same irrespective of whether the
application is signed by a pen and ink ``wet'' signature or by
attestation. The only difference will be the method of signature.
In addition, consistent with Department of Treasury guidelines, the
RRB proposes revisions to Forms AA-1 and AA-1cert to provide claimants
a debit card payment option. Other non-burden-impacting editorial and
formatting changes are proposed. One response is requested of each
respondent. Completion of the forms is required to obtain a benefit.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (77 FR 1093 on January 9, 2012) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

Title: Application for Employee Annuity Under the Railroad
Retirement Act.
OMB Control Number: 3220-0002.
Form(s) submitted: AA-1, AA-1cert, AA-1d, AA-1sum and G-204.
Type of request: Revision of a currently approved collection.
Affected public: Individuals or Households.
Abstract: The Railroad Retirement Act provides for payment of age,
disability and supplemental annuities to qualified employees. The
application and related forms obtain information about the applicant's
family work history, military service, disability benefits from other
government agencies and public or private pensions. The information is
used to determine entitlement to and the amount of the annuity applied
for.
Changes proposed: The RRB proposes revisions to Forms AA-1 and AA-
1cert to provide claimants with a debit card payment option. The RRB
also proposes the creation of Form AA-1sum, Application Summary, which
will be produced at the end of the AA-1 interview process for
documenting the alternate signing method called ``Attestation.'' The
RRB proposes no revisions to Forms AA-1d or G-204.
The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
Annual Time Burden
Form No. responses (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
AA-1 (without assistance)....................................... 100 62 103
AA-1cert (with assistance)...................................... 4,900 30 2,450
AA-1d (with assistance)......................................... 3,700 35 2,158
AA-1d (without assistance)...................................... 5 60 5
AA-1sum (with assistance)....................................... 9,100 29 4,398
G-204........................................................... 20 15 5
-----------------------------------------------
Total....................................................... 17,825 .............. 9,119
----------------------------------------------------------------------------------------------------------------

2. Title and purpose of information collection: Application for
Survivor Insurance Annuities; OMB 3220-0030.
Under Section 2(d) of the Railroad Retirement Act (RRA), monthly
survivor annuities are payable to surviving widow(er)s, parents,
unmarried children, and in certain cases, divorced spouses, mothers
(fathers), remarried widow(er)s, and grandchildren of deceased railroad
employees if there are no qualified survivors of the employee
immediately eligible for an annuity. The requirements relating to the
annuities are prescribed in 20 CFR 216, 217, 218, and 219.
To collect the information needed to help determine an applicant's
entitlement to, and the amount of, a survivor annuity the RRB uses
Forms AA-17, Application for Widow(er)'s Annuity; AA-17b, Applications
for Determination of Widow(er)'s Disability; AA-18, Application for
Mother's/Father's and Child's Annuity; AA-19, Application for Child's
Annuity; AA-19a, Application for Determination of Child's Disability;
AA-20, Application for Parent's Annuity, and electronic Form AA-17cert,
Application Summary and Certification.
The AA-17 application process obtains information from an applicant
about their marital history, work history, benefits from other
government agencies, and Medicare entitlement for a survivor annuity.
An RRB representative interviews the applicant either at a field office
(preferred), an itinerant point, or by telephone. During the interview,
the RRB representative enters the information obtained into an on-line
information system. Upon completion of the interview, the system
generates, for the applicant's review and traditional pen and ink
``wet'' signature, Form AA-17cert, Application Summary

[[Page 66879]]

and Certification, which is a summary of the information that the
applicant provided or verified. When the RRB representative is unable
to contact the applicant in person or by telephone, for example, the
applicant lives in another country, a manual version of Form AA-17 is
used.
Consistent with 20 CFR 217.17, upon completion of the AA-17
interview process, the RRB proposes to provide, in addition to the
current Form AA-17cert pen and ink ``wet'' signature, an alternate
signing method called ``Attestation,'' which will be documented by new
Form AA-17sum, Application Summary. Attestation refers to an action
taken by the RRB representative to confirm and annotate in the RRB
records (1) the applicant's intent to file an application; (2) the
applicant's affirmation under penalty of perjury that the information
provided is correct; and (3) the applicant's agreement to sign the
application by proxy. The information collected as part of the AA-17
interview process will be the same irrespective of whether the
application is signed by a pen and ink ``wet'' signature or by
attestation. The only difference will be the method of signature.
In addition, consistent with Department of Treasury guidelines, the
RRB proposes revisions to Forms AA-17, AA-17cert, AA-18, AA-19, and AA-
20cert to provide claimants a debit card payment option. Other non-
burden-impacting editorial and formatting changes are proposed. No
changes are proposed to Forms AA-17b and AA-19a. One response is
requested of each respondent. Completion of the forms is required to
obtain a benefit.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (77 FR 1093 on January 9, 2012) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

Title: Application for Survivor Insurance Annuities.
OMB Control Number: 3220-0030.
Form(s) submitted: AA-17, AA-17b, AA-17cert, AA-17sum, AA-18, AA-
19, AA-19a, and AA-20cert.
Type of request: Revision of a currently approved collection.
Affected public: Individuals or Households.
Abstract: Under Section 2(d) of the Railroad Retirement Act,
monthly survivor annuities are payable to surviving widow(er)s,
parents, unmarried children, and in certain cases, divorced wives
(husbands), mothers (fathers), remarried widow(er)s and grandchildren
of deceased railroad employees. The collection obtains information
needed by the RRB for determining entitlement to and amount of the
annuity applied for.
Changes proposed: The RRB proposes revisions to Forms AA-17, AA-
17cert, AA-18, AA-19, and AA-20cert to provide claimants with a debit
card payment option. The RRB also proposes the creation of Form AA-
17sum, Application Summary, to be produced at the end of the AA-17
interview process for claimants who choose the alternate signing method
called ``Attestation.'' Other non-burden-impacting editorial and
formatting changes are proposed. No changes are proposed to Forms AA-
17b and AA-19a.
The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
Annual Time Burden
Form No. responses (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
AA-17 (without assistance)...................................... 100 47 78
AA-17b (with assistance)........................................ 280 40 187
AA-17b (without assistance)..................................... 20 50 17
AA-17cert (with assistance)..................................... 900 20 300
AA-17sum (with assistance)...................................... 2,100 19 665
AA-18 (without assistance)...................................... 12 47 9
AA-19 (without assistance)...................................... 9 47 7
AA-19a (with assistance)........................................ 285 45 214
AA-19a (without assistance)..................................... 15 65 16
AA-20 (without assistance)...................................... 1 47 1
-----------------------------------------------
Total..................................................... 3,722 .............. 1,494
----------------------------------------------------------------------------------------------------------------

3. Title and purpose of information collection: Application for
Spouse Annuity Under the Railroad Retirement Act; OMB 3220-0042.
Section 2(c) of the Railroad Retirement Act (RRA), provides for the
payment of annuities to spouses of railroad retirement annuitants who
meet the requirements under the RRA. The age requirements for a spouse
annuity depend on the employee's age, date of retirement, and years of
railroad service. The requirements relating to the annuities are
prescribed in 20 CFR 216, 218, 219, 232, 234, and 295.
To collect the information needed to help determine an applicant's
entitlement to, and the amount of, a spouse annuity the RRB uses Form
AA-3, Application for Spouse/Divorced Spouse Annuity, and electronic
Form AA-3cert, Application Summary and Certification.
The AA-3 application process gathers information from an applicant
about their marital history, work history, benefits from other
government agencies, railroad pensions and Medicare entitlement for a
spouse annuity. An RRB representative interviews the applicant either
at a field office (preferred), an itinerant point, or by telephone.
During the interview, the RRB representative enters the information
obtained into an on-line information system. Upon completion of the
interview, the system generates, for the applicant's review and
traditional pen and ink ``wet'' signature, Form AA-3cert, Application
Summary and Certification, which is a summary of the information that
the applicant provided or verified. When the RRB representative is
unable to contact the applicant in person or by telephone, for example,
the applicant lives in another country, a manual version of Form AA-3
is used.
Consistent with 20 CFR 217.17, upon completion of the AA-3
interview process, the RRB proposes to provide, in addition to the
current Form AA-3cert pen and ink ``wet'' signature, an alternate
signing method called ``Attestation,'' which will be documented by new
form AA-3sum, Application Summary. Attestation refers to an action
taken by the RRB representative to confirm and annotate in the RRB
records (1) the applicant's intent to file an application; (2) the
applicant's affirmation under penalty of perjury that the information
provided is

[[Page 66880]]

correct; and (3) the applicant's agreement to sign the application by
proxy. The information collected as part of the AA-3 interview process
will be the same irrespective of whether the application is signed by a
pen and ink ``wet'' signature or by attestation. The only difference
will be the method of signature.
In addition, consistent with Department of Treasury guidelines, the
RRB proposes revisions to Forms AA-3 and AA-3cert to provide claimants
a debit card payment option. Other non-burden-impacting editorial and
formatting changes are proposed. One response is requested of each
respondent. Completion of the forms is required to obtain a benefit.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (77 FR 1093 on January 9, 2012) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

Title: Application for Spouse Annuity Under the Railroad Retirement
Act.
OMB Control Number: 3220-0042.
Form(s) submitted: AA-3, AA-3cert, and AA-3sum.
Type of request: Revision of a currently approved collection.
Affected public: Individuals or Households.
Abstract: The Railroad Retirement Act provides for the payment of
annuities to spouses of railroad retirement annuitants who meet the
requirements under the Act. The application obtains information
supporting the claim for benefits based on being a spouse of an
annuitant. The information is used for determining entitlement to and
amount of the annuity applied for.
Changes proposed: The RRB proposes revisions to Forms AA-3 and AA-
3cert to provide claimants with a debit card payment option. The RRB
also proposes the creation of Form AA-3sum, Application Summary, to be
produced at the end of the AA-3 interview process for claimants who
choose the alternate signing method called ``Attestation.'' Other non-
burden-impacting editorial and formatting changes are proposed.
The burden estimate for the ICR is as follows:

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 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,
Chief of Information Resources Management.
[FR Doc. 2012-27114 Filed 11-6-12; 8:45 am]
BILLING CODE 7905-01-P

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