Agency Forms Submitted for OMB Review, Request for Comments, 66877-66880 [2012-27114]
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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.
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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]
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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:
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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 ......................................................................................................................................
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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.
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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.
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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
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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 ..................................................................................................................................
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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
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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
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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
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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
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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
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(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
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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,
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]]>Agencies
[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:
----------------------------------------------------------------------------------------------------------------
Annual Time Burden
Form No. responses (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
AA-3 (without assistance)....................................... 250 58 242
AA-3cert (with assistance)...................................... 3,700 30 1,850
AA-3sum (with assistance)....................................... 7,100 29 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
