Agency Forms Submitted for OMB Review, Request for Comments, 78505-78507 [2014-30497]
Download as PDF
<![CDATA[
Federal Register / Vol. 79, No. 249 / Tuesday, December 30, 2014 / Notices
POSTAL SERVICE
Product Change—Priority Mail Express
Negotiated Service Agreement
Postal ServiceTM.
Notice.
AGENCY:
ACTION:
The Postal Service gives
notice of filing a request with the Postal
Regulatory Commission to add a
domestic shipping services contract to
the list of Negotiated Service
Agreements in the Mail Classification
Schedule’s Competitive Products List.
DATES: Effective date: December 30,
2014.
SUMMARY:
FOR FURTHER INFORMATION CONTACT:
Elizabeth A. Reed, 202–268–3179.
The
United States Postal Service® hereby
gives notice that, pursuant to 39 U.S.C.
3642 and 3632(b)(3), on December 22,
2014, it filed with the Postal Regulatory
Commission a Request of the United
States Postal Service to Add Priority
Mail Express Contract 25 to Competitive
Product List. Documents are available at
www.prc.gov, Docket Nos. MC2015–22,
CP2015–28.
SUPPLEMENTARY INFORMATION:
Stanley F. Mires,
Attorney, Federal Requirements.
[FR Doc. 2014–30425 Filed 12–29–14; 8:45 am]
BILLING CODE 7710–12–P
RAILROAD RETIREMENT BOARD
Agency Forms Submitted for OMB
Review, Request for Comments
In accordance with the
Paperwork Reduction Act of 1995 (44
U.S.C. Chapter 35), the Railroad
Retirement Board (RRB) is an
forwarding Information Collection
Request (ICR) to the Office of
Information and Regulatory Affairs
(OIRA), Office of Management and
Budget (OMB). Our ICR describes the
information we seek to collect from the
public. Review and approval by OIRA
ensures that we impose appropriate
paperwork burdens.
The RRB invites comments on the
proposed collections of information to
determine (1) the practical utility of the
collections; (2) the accuracy of the
estimated burden of the collections; (3)
ways to enhance the quality, utility, and
clarity of the information that is the
subject of collection; and (4) ways to
minimize the burden of collections on
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
mstockstill on DSK4VPTVN1PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
21:42 Dec 29, 2014
Jkt 235001
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: Railroad Service and
Compensation Reports/System Access
Application; OMB 3220–0008.
Under Section 9 of the Railroad
Retirement Act (RRA) and Section 6 of
the Railroad Unemployment Insurance
Act (RUIA) the Railroad Retirement
Board (RRB) maintains for each railroad
employee, a record of compensation
paid to that employee by all railroad
employers for whom the employee
worked after 1936. This record, which is
used by the RRB to determine eligibility
for, and amount of, benefits due under
the laws it administers, is conclusive as
to the amount of compensation paid to
an employee during such period(s)
covered by the report(s) of the
compensation by the employee’s
railroad employer(s), except in cases
when an employee files a protest
pertaining to his or her reported
compensation within the statute of
limitations cited in Section 9 of the RRA
and Section 6 of the RUIA.
To enable the RRB to establish and
maintain the record of compensation,
employers are required to file with the
RRB, reports of their employees’
compensation, in such manner and form
and at such times as the RRB prescribes.
Railroad employers’ reports and
responsibilities are prescribed in 20 CFR
209. The RRB currently utilizes Form
BA–3, Annual Report of Creditable
Compensation, and Form BA–4, Report
of Creditable Compensation
Adjustments, to secure the required
information from railroad employers.
Form BA–3 provides the RRB with
information regarding annual creditable
service and compensation for each
individual who worked for a railroad
employer covered by the RRA and RUIA
in a given year. Form BA–4 provides for
the adjustment of any previously
submitted reports and also the
opportunity to provide any service and
compensation that had been previously
omitted. Requirements specific to Forms
BA–3 and BA–4 are prescribed in 20
CFR 209.8 and 209.9.
Employers currently have the option
of submitting BA–3 and BA–4 reports
electronically by CD–ROM, File
Transfer Protocol (FTP), secure Email,
or online via the RRB’s Employer
Reporting System (ERS).
The information collection also
includes RRB Form BA–12, Application
for Employer Reporting Internet Access,
and Form G–440, Report Specifications
Sheet. Form BA–12 is completed by
railroad employers to obtain system
PO 00000
Frm 00125
Fmt 4703
Sfmt 4703
78505
access to ERS. Once access is obtained,
authorized employees may submit
reporting forms online to the RRB. The
form determines what degree of access
(view/only, data entry/modification or
approval/submission) is appropriate for
that employee. It is also used to
terminate an employee’s access to ERS.
Form G–440, Report Specifications
Sheet, serves as a certification document
for various RRB employer reporting
forms (Form BA–3, Form BA–4, Form
BA–6a, BA–6, Address Report (OMB
3220–0005), Form BA–9, Report of
Separation Allowance or Severance Pay
(OMB 3220–0173) and Form BA–11,
Report of Gross Earnings (OMB 3220–
0132)). It records the type of medium
the report was submitted on, and serves
as a summary recapitulation sheet for
reports filed on paper.
Previous Requests for Comments: The
RRB has already published the initial
60-day notice (79 FR 63652 on October
24, 2014) required by 44 U.S.C.
3506(c)(2). On November 25, 2014, the
RRB received comments from the
Department of Commerce’s Bureau of
Economic Analysis (BEA), strongly
supporting the RRB’s continued
collection of the data on Forms BA–3
and BA–4 stating ‘‘these forms are our
main data source for key components of
BEA’s economic statistics.’’
Information Collection Request (ICR)
Title: Railroad Service and
Compensation Reports/System Access
Application.
OMB Control Number: 3220–0008.
Form(s) submitted: BA–3, BA–3
(Internet), BA–4, BA–4 (Internet), BA–
12 and G–440.
Type of request: Revision of a
currently approved collection.
Affected public: Private Sector;
Businesses or other for-profits.
Abstract: Under the Railroad
Retirement Act and the Railroad
Unemployment Insurance Act,
employers are required to report service
and compensation for each employee to
update Railroad Retirement Board
records for payments of benefits. The
collection obtains service and
compensation information and
information needed to ensure secure
system access from employers who
voluntarily opt to use the RRB’s
Internet-based Employer Reporting
System to submit reporting forms and
information needed to certify employer
reporting transactions.
Changes proposed: The RRB proposes
to eliminate the paper version of Form
BA–3 and to make minor non-burden
impacting changes to Forms BA–12.
The burden estimate for the ICR is as
follows:
E:\FR\FM\30DEN1.SGM
30DEN1
78506
Federal Register / Vol. 79, No. 249 / Tuesday, December 30, 2014 / Notices
Responses
Time
(minutes)
Burden
(hours)
BA–3:
Electronic Media ....................................................
BA–3 (Internet) ......................................................
........................
96
617
.......................................................................................
46.25 (2,775 min) .........................................................
46.25 (2,775 min) .........................................................
........................
4,440
28,536
Total BA–3 .....................................................
BA–4:
Paper .....................................................................
Electronic Media ....................................................
BA–4 (Internet) ......................................................
713
........................
160
285
3,852
.......................................................................................
.......................................................................................
1.25 (75 min) ................................................................
1.00 (60 min) ................................................................
.33 (20 min) ..................................................................
32,976
........................
200
285
1,284
Total BA–4 .....................................................
BA–12:
Initial Access .........................................................
Access Termination ...............................................
4,297
........................
295
38
.......................................................................................
.......................................................................................
.33 (20 min) ..................................................................
.166 (10 min) ................................................................
1,769
........................
98
6
Total BA–12 ...................................................
G–440 (Certification): ...................................................
Form BA–3 (zero employees) ...............................
Form BA–11 (zero employees) .............................
Paper forms (without recap) ..................................
Electronic transactions ..........................................
BA–3 and BA–4 (with recap) ................................
333
........................
19
60
7
94
125
.......................................................................................
.......................................................................................
.25 (15 min) ..................................................................
.25 (15 min) ..................................................................
.25 (15 min) ..................................................................
.50 (30 min) ..................................................................
1.25 (75 min) ................................................................
105
........................
5
15
2
47
156
Total G–440 ...................................................
305
.......................................................................................
224
Grand Total .............................................
mstockstill on DSK4VPTVN1PROD with NOTICES
Reporting
5,648
.......................................................................................
35,074
2. Title and Purpose of information
collection: Medical Reports; OMB 3220–
0038.
Under sections 2(a)(1)(iv) and
2(a)(1)(v) of the Railroad Retirement Act
(RRA), annuities are payable to qualified
railroad employees whose physical or
mental condition makes them unable to
(1) work in their regular occupation
(occupational disability) or (2) work at
all (permanent total disability). The
requirements for establishing disability
and proof of continuing disability under
the RRA are prescribed in 20 CFR 220.
Under Sections 2(c)(1)(ii)(C) and
2(d)(1)(ii) of the RRA, annuities are also
payable to qualified spouses and
widow(er)s, respectively, who have a
qualifying child who became disabled
before age 22. Annuities are also
payable to surviving children on the
basis of disability under section
2(d)(1)(iii)(C) if the child’s disability
began before age 22 as well as to
widow(er)s on the basis of disability
under section 2(d)(1)(i)(B). To meet the
disability standard, the RRA provides
that individuals must have a permanent
physical or mental condition that makes
them unable to engage in any regular
employment.
Under section 2(d)(1)(v) of the RRA,
annuities are also payable to remarried
widow(er)s and surviving divorced
spouses on the basis of, among other
things, disability or having a qualifying
disabled child in care. However, the
VerDate Sep<11>2014
21:42 Dec 29, 2014
Jkt 235001
disability standard in these cases is that
found in the Social Security Act. That
is, individuals must be unable to engage
in any substantial gainful activity by
reason of any medically determinable
physical or mental impairment. The
RRB also determines entitlement to a
Period of Disability and entitlement to
early Medicare based on disability for
qualified claimants in accordance with
Section 216 of the Social Security Act.
When making disability
determinations, the RRB needs evidence
from acceptable medical sources. The
RRB currently utilizes Forms G–3EMP,
Report of Medical Condition by
Employer; G–197, Authorization to
Release Medical Information to the
Railroad Retirement Board; G–250,
Medical Assessment; G–250A, Medical
Assessment of Residual Functional
Capacity; G–260, Report of Seizure
Disorder; RL–11B, Disclosure of
Hospital Medical Records; RL–11D,
Disclosure of Medical Records from a
State Agency; and RL–250, Request for
Medical Assessment, to obtain the
necessary medical evidence. One
response is requested of each
respondent. Completion is voluntary.
Previous Requests for Comments: The
RRB has already published the initial
60-day notice (79 FR 63653 on October
24, 2014) required by 44 U.S.C.
3506(c)(2).
Information Collection Request (ICR)
Title: Medical Reports.
PO 00000
Frm 00126
Fmt 4703
Sfmt 4703
OMB Control Number: 3220–0038.
Form(s) submitted: G–3EMP, G–197,
G–250, G–250a, G–260, RL–11B, RL–
11D, RL–250.
Type of request: Revision of a
currently approved collection of
information.
Affected public: Individuals or
households; Private Sector; State, Local
and Tribal Government.
Abstract: The Railroad Retirement Act
provides disability annuities for
qualified railroad employees whose
physical or mental condition renders
them incapable of working in their
regular occupation (occupational
disability) or any occupation (total
disability). The medical reports obtain
information needed for determining the
nature and severity of the impairment.
Changes proposed: The RRB proposes
to add a fraud statement; request a
doctor’s National Provider Number; and
make other minor non-burden
impacting editorial and cosmetic
changes to Forms G–250, G–250A, and
G–260. The RRB also proposes to revise
Form G–197 to include authorization to
disclose educational records from
various sources, as well as make other
minor non-burden impacting editorial
changes. There are no proposed changes
to Forms RL–11B, RL–11D, RL–250.
The burden estimate for the ICR is as
follows:
E:\FR\FM\30DEN1.SGM
30DEN1
Federal Register / Vol. 79, No. 249 / Tuesday, December 30, 2014 / Notices
Annual
responses
Form No.
G–3EMP ......................................................................................................................................
G–197 ..........................................................................................................................................
G–250 ..........................................................................................................................................
G–250A ........................................................................................................................................
G–260 ..........................................................................................................................................
RL–11B ........................................................................................................................................
RL–11D ........................................................................................................................................
RL–250 ........................................................................................................................................
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. 2014–30497 Filed 12–29–14; 8:45 am]
BILLING CODE 7905–01–P
SECURITIES AND EXCHANGE
COMMISSION
[Release No. 34–73911; File No. 10–214]
Automated Matching Systems
Exchange, LLC; Notice of Filing of
Amendment No. 1 to an Application for
Limited Volume Exemption From
Registration as a National Securities
Exchange Under Section 5 of the
Securities Exchange Act of 1934
mstockstill on DSK4VPTVN1PROD with NOTICES
December 22, 2014.
On July 7, 2014, Automated Matching
Systems Exchange, LLC (‘‘AMSE’’)
submitted to the Securities and
Exchange Commission (‘‘SEC’’ or
‘‘Commission’’) an application seeking a
limited volume exemption under
Section 5 of the Securities Exchange Act
(‘‘Exchange Act’’) from registration as a
national securities exchange under
Section 6 of the Exchange Act.1 Notice
of AMSE’s exemption application was
published for comment in the Federal
Register on July 29, 2014.2 On October
23, 2014, the Commission issued an
1 The
Commission notes that AMSE’s application
only seeks a limited volume exemption under
Section 5 of the Exchange Act from registration as
a national securities exchange under Section 6 of
the Exchange Act. AMSE’s application does not
seek to register as a national securities exchange.
2 See Securities Exchange Act Release No. 72661
(July 23, 2014), 79 FR 44070 (‘‘Notice’’).
VerDate Sep<11>2014
22:38 Dec 29, 2014
Jkt 235001
order instituting proceedings to
determine whether to grant or deny
AMSE’s exemption application.3 On
November 10, 2014, AMSE submitted
Amendment No. 1 to its exemption
application. The Commission is
publishing this notice in order to solicit
views of interested persons on AMSE’s
exemption application as amended by
Amendment No. 1.
I. Description of AMSE’s System
AMSE proposes to conduct business
in reliance upon an exemption from
registration as a national securities
exchange pursuant to Section 5 of the
Exchange Act.4 In general, AMSE seeks
to operate as an exchange for alternative
trading systems.5 AMSE proposes to
operate solely on an ‘‘off-order-book’’
trading basis. AMSE does not intend to
have a physical exchange trading floor,
centralized order book, or specialists or
market makers with affirmative and
negative market making obligations.
Each member of AMSE would maintain
its own automated matching system or
electronic order book. Each member of
AMSE would adopt its own rules
governing the execution and priority of
orders on its system. Trades would
occur when an order to buy and an
order to sell match on a member’s
electronic order book. Each member
would report its transactions to AMSE
at such intervals as required by AMSE.
II. Amendment No. 1 to AMSE’s
Exemption Application
On November 10, 2014, AMSE
submitted Amendment No. 1 to its
exemption application. AMSE has
represented that the only substantive
change to its exemption application
made by Amendment No. 1 is the
3 See Securities Exchange Act Release No. 73419
(October 23, 2014), 79 FR 64421 (October 29, 2014)
(‘‘Order Instituting Proceedings’’).
4 15 U.S.C. 78e.
5 For more detail on AMSE’s proposed system,
see AMSE’s full amended exemption application
and exhibits, which are published with this notice
on the Commission’s Web site at https://
www.sec.gov/rules/other.shtml.
PO 00000
Frm 00127
Fmt 4703
Sfmt 4703
600
6,000
11,950
50
100
5,000
250
11,950
35,900
Time
(minutes)
10
10
30
20
25
10
10
10
........................
78507
Burden
(hours)
100
1,000
5,975
17
42
833
42
1,992
10,001
addition of the following paragraph to
Exhibit E: 6
The Exchange will bring together orders for
multiple buyers and sellers and such will be
done by the use of consolidated quotation
systems which effect transactions for
multiple buyers and sellers. The consolidated
quotation systems will display, or otherwise
represent, trading interests entered on the
AMSE system to its system users. AMSE may
use a centralized order router which would
match trading interests on the electronic
order book of one member with the trading
interests on the electronic order book of a
second member.
III. Additional Grounds for Denial
Under Consideration
In the Order Instituting Proceedings,
the Commission provided notice of the
grounds for denial under
consideration.7 Specifically, the
Commission noted that it was
concerned that AMSE’s exemption
application does not meet a key
threshold requirement for being granted
an exemption from exchange
registration—namely, that the applicant
actually be an ‘‘exchange’’ as defined
under Section 3(a)(1) of the Exchange
Act and Rule 3b–16 thereunder.8 The
Commission continues to have this
concern.
The Commission is providing notice
of additional grounds for denial under
consideration. Specifically, the
Commission is concerned that it would
not be necessary or appropriate in the
public interest or for the protection of
investors to grant a limited volume
exemption under Section 5 of the
Exchange Act because it appears from
the exemption application that the
operation of the proposed exchange
would be inconsistent with the
Exchange Act.
6 See email from Michael Stegawski, Chief
Regulatory Officer, AMSE, to SEC staff, dated
November 14, 2014.
7 See Order Instituting Proceedings, supra note 3,
at 64422.
8 See Regulation ATS Adopting Release, 63 FR at
70898–70901 (discussing the Commission’s revised
interpretation of the ‘‘exchange’’ definition). Among
other things, the Commission stated that ‘‘the first
essential element of an exchange is the bringing
together of orders of multiple buyers and sellers.’’
Id. at 70900.
E:\FR\FM\30DEN1.SGM
30DEN1
]]>Agencies
[Federal Register Volume 79, Number 249 (Tuesday, December 30, 2014)]
[Notices]
[Pages 78505-78507]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-30497]
=======================================================================
-----------------------------------------------------------------------
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 an
forwarding Information Collection Request (ICR) to the Office of
Information and Regulatory Affairs (OIRA), Office of Management and
Budget (OMB). Our ICR describes the information we seek to collect from
the public. Review and approval by OIRA ensures that we impose
appropriate paperwork burdens.
The RRB invites comments on the proposed collections of information
to determine (1) the practical utility of the collections; (2) the
accuracy of the estimated burden of the collections; (3) ways to
enhance the quality, utility, and clarity of the information that is
the subject of collection; and (4) ways to minimize the burden of
collections on 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: Railroad Service
and Compensation Reports/System Access Application; OMB 3220-0008.
Under Section 9 of the Railroad Retirement Act (RRA) and Section 6
of the Railroad Unemployment Insurance Act (RUIA) the Railroad
Retirement Board (RRB) maintains for each railroad employee, a record
of compensation paid to that employee by all railroad employers for
whom the employee worked after 1936. This record, which is used by the
RRB to determine eligibility for, and amount of, benefits due under the
laws it administers, is conclusive as to the amount of compensation
paid to an employee during such period(s) covered by the report(s) of
the compensation by the employee's railroad employer(s), except in
cases when an employee files a protest pertaining to his or her
reported compensation within the statute of limitations cited in
Section 9 of the RRA and Section 6 of the RUIA.
To enable the RRB to establish and maintain the record of
compensation, employers are required to file with the RRB, reports of
their employees' compensation, in such manner and form and at such
times as the RRB prescribes. Railroad employers' reports and
responsibilities are prescribed in 20 CFR 209. The RRB currently
utilizes Form BA-3, Annual Report of Creditable Compensation, and Form
BA-4, Report of Creditable Compensation Adjustments, to secure the
required information from railroad employers. Form BA-3 provides the
RRB with information regarding annual creditable service and
compensation for each individual who worked for a railroad employer
covered by the RRA and RUIA in a given year. Form BA-4 provides for the
adjustment of any previously submitted reports and also the opportunity
to provide any service and compensation that had been previously
omitted. Requirements specific to Forms BA-3 and BA-4 are prescribed in
20 CFR 209.8 and 209.9.
Employers currently have the option of submitting BA-3 and BA-4
reports electronically by CD-ROM, File Transfer Protocol (FTP), secure
Email, or online via the RRB's Employer Reporting System (ERS).
The information collection also includes RRB Form BA-12,
Application for Employer Reporting Internet Access, and Form G-440,
Report Specifications Sheet. Form BA-12 is completed by railroad
employers to obtain system access to ERS. Once access is obtained,
authorized employees may submit reporting forms online to the RRB. The
form determines what degree of access (view/only, data entry/
modification or approval/submission) is appropriate for that employee.
It is also used to terminate an employee's access to ERS. Form G-440,
Report Specifications Sheet, serves as a certification document for
various RRB employer reporting forms (Form BA-3, Form BA-4, Form BA-6a,
BA-6, Address Report (OMB 3220-0005), Form BA-9, Report of Separation
Allowance or Severance Pay (OMB 3220-0173) and Form BA-11, Report of
Gross Earnings (OMB 3220-0132)). It records the type of medium the
report was submitted on, and serves as a summary recapitulation sheet
for reports filed on paper.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (79 FR 63652 on October 24, 2014) required by 44
U.S.C. 3506(c)(2). On November 25, 2014, the RRB received comments from
the Department of Commerce's Bureau of Economic Analysis (BEA),
strongly supporting the RRB's continued collection of the data on Forms
BA-3 and BA-4 stating ``these forms are our main data source for key
components of BEA's economic statistics.''
Information Collection Request (ICR)
Title: Railroad Service and Compensation Reports/System Access
Application.
OMB Control Number: 3220-0008.
Form(s) submitted: BA-3, BA-3 (Internet), BA-4, BA-4 (Internet),
BA-12 and G-440.
Type of request: Revision of a currently approved collection.
Affected public: Private Sector; Businesses or other for-profits.
Abstract: Under the Railroad Retirement Act and the Railroad
Unemployment Insurance Act, employers are required to report service
and compensation for each employee to update Railroad Retirement Board
records for payments of benefits. The collection obtains service and
compensation information and information needed to ensure secure system
access from employers who voluntarily opt to use the RRB's Internet-
based Employer Reporting System to submit reporting forms and
information needed to certify employer reporting transactions.
Changes proposed: The RRB proposes to eliminate the paper version
of Form BA-3 and to make minor non-burden impacting changes to Forms
BA-12.
The burden estimate for the ICR is as follows:
[[Page 78506]]
----------------------------------------------------------------------------------------------------------------
Burden
Reporting Responses Time (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
BA-3: .............. ................................ ..............
Electronic Media.......................... 96 46.25 (2,775 min)............... 4,440
BA-3 (Internet)........................... 617 46.25 (2,775 min)............... 28,536
-----------------------------------------------------------------
Total BA-3............................ 713 ................................ 32,976
BA-4: .............. ................................ ..............
Paper..................................... 160 1.25 (75 min)................... 200
Electronic Media.......................... 285 1.00 (60 min)................... 285
BA-4 (Internet)........................... 3,852 .33 (20 min).................... 1,284
-----------------------------------------------------------------
Total BA-4............................ 4,297 ................................ 1,769
BA-12: .............. ................................ ..............
Initial Access............................ 295 .33 (20 min).................... 98
Access Termination........................ 38 .166 (10 min)................... 6
-----------------------------------------------------------------
Total BA-12........................... 333 ................................ 105
G-440 (Certification):........................ .............. ................................ ..............
Form BA-3 (zero employees)................ 19 .25 (15 min).................... 5
Form BA-11 (zero employees)............... 60 .25 (15 min).................... 15
Paper forms (without recap)............... 7 .25 (15 min).................... 2
Electronic transactions................... 94 .50 (30 min).................... 47
BA-3 and BA-4 (with recap)................ 125 1.25 (75 min)................... 156
-----------------------------------------------------------------
Total G-440........................... 305 ................................ 224
-----------------------------------------------------------------
Grand Total....................... 5,648 ................................ 35,074
----------------------------------------------------------------------------------------------------------------
2. Title and Purpose of information collection: Medical Reports;
OMB 3220-0038.
Under sections 2(a)(1)(iv) and 2(a)(1)(v) of the Railroad
Retirement Act (RRA), annuities are payable to qualified railroad
employees whose physical or mental condition makes them unable to (1)
work in their regular occupation (occupational disability) or (2) work
at all (permanent total disability). The requirements for establishing
disability and proof of continuing disability under the RRA are
prescribed in 20 CFR 220.
Under Sections 2(c)(1)(ii)(C) and 2(d)(1)(ii) of the RRA, annuities
are also payable to qualified spouses and widow(er)s, respectively, who
have a qualifying child who became disabled before age 22. Annuities
are also payable to surviving children on the basis of disability under
section 2(d)(1)(iii)(C) if the child's disability began before age 22
as well as to widow(er)s on the basis of disability under section
2(d)(1)(i)(B). To meet the disability standard, the RRA provides that
individuals must have a permanent physical or mental condition that
makes them unable to engage in any regular employment.
Under section 2(d)(1)(v) of the RRA, annuities are also payable to
remarried widow(er)s and surviving divorced spouses on the basis of,
among other things, disability or having a qualifying disabled child in
care. However, the disability standard in these cases is that found in
the Social Security Act. That is, individuals must be unable to engage
in any substantial gainful activity by reason of any medically
determinable physical or mental impairment. The RRB also determines
entitlement to a Period of Disability and entitlement to early Medicare
based on disability for qualified claimants in accordance with Section
216 of the Social Security Act.
When making disability determinations, the RRB needs evidence from
acceptable medical sources. The RRB currently utilizes Forms G-3EMP,
Report of Medical Condition by Employer; G-197, Authorization to
Release Medical Information to the Railroad Retirement Board; G-250,
Medical Assessment; G-250A, Medical Assessment of Residual Functional
Capacity; G-260, Report of Seizure Disorder; RL-11B, Disclosure of
Hospital Medical Records; RL-11D, Disclosure of Medical Records from a
State Agency; and RL-250, Request for Medical Assessment, to obtain the
necessary medical evidence. One response is requested of each
respondent. Completion is voluntary.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (79 FR 63653 on October 24, 2014) required by 44
U.S.C. 3506(c)(2).
Information Collection Request (ICR)
Title: Medical Reports.
OMB Control Number: 3220-0038.
Form(s) submitted: G-3EMP, G-197, G-250, G-250a, G-260, RL-11B, RL-
11D, RL-250.
Type of request: Revision of a currently approved collection of
information.
Affected public: Individuals or households; Private Sector; State,
Local and Tribal Government.
Abstract: The Railroad Retirement Act provides disability annuities
for qualified railroad employees whose physical or mental condition
renders them incapable of working in their regular occupation
(occupational disability) or any occupation (total disability). The
medical reports obtain information needed for determining the nature
and severity of the impairment.
Changes proposed: The RRB proposes to add a fraud statement;
request a doctor's National Provider Number; and make other minor non-
burden impacting editorial and cosmetic changes to Forms G-250, G-250A,
and G-260. The RRB also proposes to revise Form G-197 to include
authorization to disclose educational records from various sources, as
well as make other minor non-burden impacting editorial changes. There
are no proposed changes to Forms RL-11B, RL-11D, RL-250.
The burden estimate for the ICR is as follows:
[[Page 78507]]
----------------------------------------------------------------------------------------------------------------
Annual Time Burden
Form No. responses (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
G-3EMP.......................................................... 600 10 100
G-197........................................................... 6,000 10 1,000
G-250........................................................... 11,950 30 5,975
G-250A.......................................................... 50 20 17
G-260........................................................... 100 25 42
RL-11B.......................................................... 5,000 10 833
RL-11D.......................................................... 250 10 42
RL-250.......................................................... 11,950 10 1,992
35,900 .............. 10,001
----------------------------------------------------------------------------------------------------------------
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. 2014-30497 Filed 12-29-14; 8:45 am]
BILLING CODE 7905-01-P
