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

[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