Agency Forms Submitted for OMB Review, Request for Comments, 8262-8264 [2016-03328]
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8262
Federal Register / Vol. 81, No. 32 / Thursday, February 18, 2016 / Notices
CFR part 3020, subpart B. Comments are
due no later than February 19, 2016.
The public portions of these filings can
be accessed via the Commission’s Web
site (https://www.prc.gov).
The Commission appoints Kenneth R.
Moeller to represent the interests of the
general public (Public Representative)
in this docket.
III. Ordering Paragraphs
It is ordered:
1. The Commission reopens Docket
No. CP2015–43 for consideration of
matters raised by the Postal Service’s
Notice.
2. Pursuant to 39 U.S.C. 505, the
Commission appoints Kenneth R.
Moeller to serve as an officer of the
Commission (Public Representative) to
represent the interests of the general
public in this proceeding.
3. Comments are due no later than
February 19, 2016.
4. The Secretary shall arrange for
publication of this order in the Federal
Register.
By the Commission.
Stacy L. Ruble,
Secretary.
[FR Doc. 2016–03281 Filed 2–17–16; 8:45 am]
BILLING CODE 7710–FW–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 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
SUMMARY:
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 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
Forms AA–17cert, Application
Summary and Certification, and AA–
17sum, Application Summary.
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 on-line
information system generates a
summary of the information that was
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–20.
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 to
determine entitlement to and the
amount of the annuity applied for.
Changes proposed: The RRB proposes
to remove the manual version of Forms
AA–17, AA–18, AA–19 and AA–20
from the information collection due to
receiving less than 10 responses
annually. No changes are proposed to
Forms AA–17b and AA–19a.
The burden estimate for the ICR is as
follows:
Annual
responses
Form number
mstockstill on DSK4VPTVN1PROD with NOTICES
provided on either Form AA–17cert,
Application Summary and Certification,
or Form AA–17sum, Application
Summary, for the applicant to review
and approve. Form AA–17cert
documents approval using the
traditional pen and ink ‘‘wet’’ signature,
and Form AA–17sum, documents
approval using the alternative signature
method called Attestation. 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.
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 (80 FR 75140 on
December 1, 2015) required by 44 U.S.C.
3506(c)(2). That request elicited no
comments.
AA–17 Application Process:
AA–17cert .............................................................................................................................
AA–17sum ............................................................................................................................
AA–17b:
(With assistance) ..................................................................................................................
(Without assistance) .............................................................................................................
AA–19a:
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E:\FR\FM\18FEN1.SGM
Time
(minutes)
Burden
(hours)
900
2,100
20
19
300
665
250
20
40
50
167
17
18FEN1
8263
Federal Register / Vol. 81, No. 32 / Thursday, February 18, 2016 / Notices
Annual
responses
Form number
Time
(minutes)
Burden
(hours)
(Without assistance) .............................................................................................................
(Without assistance) .............................................................................................................
200
15
45
65
150
16
Total ...............................................................................................................................
3,485
........................
1,315
2. 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 Forms
AA–3cert, Application Summary and
Certification, and AA–3sum,
Application Summary.
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 on-line information
system generates a summary of the
information that was provided on either
Form AA–3cert, Application Summary
and Certification, or Form AA–3sum,
Application Summary, for the applicant
to review and approve. Form AA–3cert
documents approval using the
traditional pen and ink ‘‘wet’’ signature,
and Form AA–3sum documents
approval using the alternative signature
method called Attestation. 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.
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 (80 FR 75141 on
December 1, 2015) 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
to remove the manual version of Form
AA–3, from the information collection
due to receiving less than 10 responses
annually.
The burden estimate for the ICR is as
follows:
Annual
responses
Form number
Time
(minutes)
Burden
(hours)
4,700
7,000
30
29
2,350
3,383
Total ...............................................................................................................................
mstockstill on DSK4VPTVN1PROD with NOTICES
AA–3 online process:
AA–3cert (with assistance) ...................................................................................................
AA–3sum (with assistance) ..................................................................................................
11,700
........................
5,733
3. Title and Purpose of information
collection: Request for Medicare
Payment; OMB 3220–0131.
Under Section 7(d) of the Railroad
Retirement Act, the RRB administers the
Medicare program for persons covered
by the railroad retirement system. The
collection obtains the information
needed by Palmetto GBA, the Medicare
carrier for railroad retirement
beneficiaries, to pay claims for
payments under Part B of the Medicare
program. Authority for collecting the
information is prescribed in 42 CFR
424.32.
The RRB currently utilizes Forms G–
740S, Patient’s Request for Medicare
Payment, along with Centers for
Medicare & Medicaid Services Form
VerDate Sep<11>2014
19:03 Feb 17, 2016
Jkt 238001
CMS–1500, to secure the information
necessary to pay Part B Medicare
Claims. One response is completed for
each claim. Completion is required to
obtain a benefit.
Previous Requests for Comments: The
RRB has already published the initial
60-day notice (80 FR 72998 on
November 23, 2015) required by 44
U.S.C. 3506(c)(2). That request elicited
no comments.
Information Collection Request (ICR)
Title: Request for Medicare Payment.
OMB Control Number: 3220–0131.
Form(s) submitted: G–740S, CMS–
1500.
PO 00000
Frm 00091
Fmt 4703
Sfmt 4703
Type of request: Extension without
change of a currently approved
collection.
Affected public: Individuals or
Households.
Abstract: The RRB administers the
Medicare program for persons covered
by the Railroad Retirement System. The
collection obtains the information
needed by Palmetto GBA, the RRB’s
carrier, to pay claims for services
covered under Part B of the program.
Changes proposed: The RRB proposes
no changes to RRB Form G–740S.
The burden estimate for the ICR is as
follows:
Estimated annual number of
respondents: See Justification (Item No.
12).
E:\FR\FM\18FEN1.SGM
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Federal Register / Vol. 81, No. 32 / Thursday, February 18, 2016 / Notices
Total annual responses: 1.
Total annual reporting hours: 1.
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. 2016–03328 Filed 2–17–16; 8:45 am]
BILLING CODE 7905–01–P
Securities and Exchange Commission
(‘‘Commission’’), pursuant to Section
11A of the Securities Exchange Act of
1934 (‘‘Act’’) 1 and Rule 608
thereunder,2 a proposal to amend the
Plan.3 The proposal represents the third
substantive amendment to the Plan
(‘‘Amendment’’) and reflects changes
unanimously approved by the Parties.4
The Amendment to the Plan proposes to
revise Section IV(d) of the Plan (Reuse
of a Symbol) to provide that, where a
Party ceases to use a symbol, such party
may elect to release the symbol and that
such symbol may not be reused to
identify a new security (other than the
security that has been trading under
such symbol) within 90 calendar days
from the last day of its use to identify
1 15
U.S.C. 78k–1.
CFR 242.608.
3 The Plan provides an orderly process for Parties
to reserve available ticker symbols for equity
securities. Specifically, each party to the Plan may
reserve a set number of 1-, 2-, or 3-character
symbols and a set number of 4- or 5-character
symbols. In the case of 1-, 2-, or 3-character
symbols, each party may reserve up to 20 symbols
perpetually (i.e., without a time limit on the
reservation) as ‘‘List A reservations,’’ and 1,500
symbols for 24 months (i.e., with a 24-month
expiration on the reservation) as ‘‘List B
reservations.’’ Each party also may reserve the same
number of symbols on a separate ‘‘List A’’ and a
separate ‘‘List B’’ for 4- or 5-character symbols.
4 On November 6, 2008, the Commission
approved the Symbology Plan that was originally
proposed by the CHX, Nasdaq, FINRA, NSX, and
Phlx, subject to certain changes. See Securities
Exchange Act Release No. 58904, 73 FR 67218
(November 13, 2008) (File No. 4–533). On
November 18, 2008, the ISE, and on December 22,
2008, NYSE, NYSE Arca, NYSE MKT (f/k/a ‘‘NYSE
Alternext US, LLC’’) and CBOE, and on December
24, 2008, NASDAQ OMX BX, filed amendments to
join the Plan, which amendments became
immediately effective upon filing. See Securities
Exchange Act Release No. 59024 (November 26,
2008), 73 FR 74538 (December 8, 2008) (File No.
4–533) (ISE filing to join the Plan); Securities
Exchange Act Release No. 59162 (December 24,
2008), 74 FR 132 (January 2, 2009) (File No. 4–533)
(NYSE, NYSE Arca, NYSE Alternext US LLC and
CBOE filing to join the Plan); and Securities
Exchange Act Release No. 59187 (December 30,
2008), 74 FR 729 (January 7, 2009) (File No. 4–533)
(NASDAQ OMX BX filing to join the Plan). On
January 5, 2009 and March 6, 2009, the Parties
amended the plan to modify certain effective dates
in the Plan, which amendments became
immediately effective upon filing. See Securities
Exchange Act Release No. 59225 (January 9, 2009),
73 FR 3117 (January 16, 2009) (File No. 4–533)
(Amendment No. 1); and Securities Exchange Act
Release No. 59574 (March 13, 2009), 74 FR 11981
(March 20, 2009) (File No. 4–533) (Amendment No.
2). On September 30, 2009, BATS, on July 7, 2010,
EDGA and EDGX, and on May 7, 2012, BOX, filed
amendments to join the Plan, which amendments
became immediately effective upon filing. See
Securities Exchange Act Release No. 60856 (October
21, 2009), 74 FR 55276 (October 27, 2009) (File No.
4–533) (BATS filing to join the Plan); Securities
Exchange Act Release No. 62573 (July 26, 2010), 75
FR 45682 (August 3, 2010) (File No. 4–533) (EDGA
and EDGX filing to join the Plan); and Securities
Exchange Act Release No. 66957 (May 10, 2012), 77
FR 28904 (May 16, 2012) (File No. 4–533) (BOX
filing to join the Plan).
2 17
SECURITIES AND EXCHANGE
COMMISSION
[Release No. 34–77123; File No. 4–533]
Joint Industry Plan; Notice of Filing of
Amendment No. 3 to the National
Market System Plan for the Selection
and Reservation of Securities Symbols
Submitted by Financial Industry
Regulatory Authority, Inc., BATS
Exchange, Inc., BOX Options
Exchange, LLC, Chicago Board
Options Exchange, Incorporated,
Chicago Stock Exchange, Inc., EDGA
Exchange, Inc., EDGX Exchange, Inc.,
International Securities Exchange,
LLC, NASDAQ OMX BX, Inc., NASDAQ
OMX PHLX, Inc., The Nasdaq Stock
Market LLC, National Stock Exchange,
Inc., New York Stock Exchange, LLC,
NYSE MKT, LLC, and NYSE Arca, Inc.
mstockstill on DSK4VPTVN1PROD with NOTICES
February 11, 2016.
On August 24, 2015, Financial
Industry Regulatory Authority, Inc.
(‘‘FINRA’’), on behalf of the following
parties to the National Market System
Plan for the Selection and Reservation
of Securities Symbols (the ‘‘Plan’’):
BATS Exchange, Inc. (‘‘BATS’’), BOX
Options Exchange, LLC (‘‘BOX’’),
Chicago Board Options Exchange,
Incorporated (‘‘CBOE’’), Chicago Stock
Exchange, Inc. (‘‘CHX’’), EDGA
Exchange, Inc. (‘‘EDGA’’), EDGX
Exchange, Inc. (‘‘EDGX’’), FINRA,
International Securities Exchange, LLC
(‘‘ISE’’), NASDAQ OMX BX, Inc.
(‘‘BX’’), NASDAQ OMX PHLX, Inc.
(‘‘Phlx’’), The Nasdaq Stock Market LLC
(‘‘Nasdaq’’), National Stock Exchange,
Inc. (‘‘NSX’’), New York Stock
Exchange, LLC (‘‘NYSE’’), NYSE MKT,
LLC (‘‘NYSE MKT’’), and NYSE Arca,
Inc. (‘‘NYSE Arca’’) (collectively with
FINRA, the ‘‘Parties’’), filed with the
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19:03 Feb 17, 2016
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Fmt 4703
Sfmt 4703
the old security, without the consent of
the Party that released the symbol. In
addition, a Party may not reuse (or
consent to the reuse of) a symbol to
identify a new security unless such
Party reasonably determines that such
use would not cause investor confusion.
The Commission is publishing this
notice to solicit comments from
interested persons on the Amendment
to the Plan.5
I. Description and Purpose of the
Amendment
The Plan was created to enhance the
effectiveness and efficiency of the
national market system and to provide
for fair competition between the selfregulatory organizations (‘‘SROs’’) by
establishing a uniform system for the
selection and reservation of securities
symbols. The Plan, among other things,
sets forth the process for securing
perpetual and limited-time reservations,
the use of a waiting list, the right to
reuse a symbol and the ability to request
the release of a symbol.
Under Section IV(d) of the current
Plan, if a Party ceases to use a symbol,
such Party automatically has that
symbol reserved for a period of 24
months, notwithstanding any other
limits on the number of reserved
symbols specified in the Plan.6
However, in the event that the Party
ceasing to use the symbol neither: (1)
Places the symbol on its List A, or (2)
uses the symbol within 24 months, the
symbol is released for use pursuant to
Section IV(b)(5) (Non-Use or Release of
Symbols Within Time Period). In such
cases, the symbol may be reused by a
different Party to identify a new security
in accordance with the procedures set
forth in the Plan. Section IV(d) of the
Plan provides that a symbol may not be
reused by a Party to identify a new
security unless the Party reasonably
determines that such use would not
cause investor confusion. Thus, even
where a Party releases a symbol for
reuse, such symbol may not be reused
to identify a new security if such use
would cause investor confusion in the
judgment of the party seeking to reuse
the symbol.
The Parties are amending Section
IV(d) of the Plan to clarify that, if a Party
ceases use of a symbol, such Party may
elect to release the symbol pursuant to
paragraph (b)(5) of the Plan. If a Party
does not release the symbol, such
5 17
CFR 242.608(b)(1).
that, pursuant to paragraph (f) of Section
IV (Portability of Symbols in Use), if a new SRO
lists a security or product that previously was listed
on another SRO, the new SRO has the right to that
symbol unless, in its discretion, it consents to the
symbol being retained by the former SRO.
6 Except
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18FEN1
]]>Agencies
[Federal Register Volume 81, Number 32 (Thursday, February 18, 2016)]
[Notices]
[Pages 8262-8264]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-03328]
=======================================================================
-----------------------------------------------------------------------
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
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 Forms AA-
17cert, Application Summary and Certification, and AA-17sum,
Application Summary.
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 on-line
information system generates a summary of the information that was
provided on either Form AA-17cert, Application Summary and
Certification, or Form AA-17sum, Application Summary, for the applicant
to review and approve. Form AA-17cert documents approval using the
traditional pen and ink ``wet'' signature, and Form AA-17sum, documents
approval using the alternative signature method called Attestation.
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.
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 (80 FR 75140 on December 1, 2015) 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-20.
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 to determine entitlement to and the amount of the
annuity applied for.
Changes proposed: The RRB proposes to remove the manual version of
Forms AA-17, AA-18, AA-19 and AA-20 from the information collection due
to receiving less than 10 responses annually. No changes are proposed
to Forms AA-17b and AA-19a.
The burden estimate for the ICR is as follows:
----------------------------------------------------------------------------------------------------------------
Annual Time Burden
Form number responses (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
AA-17 Application Process:
AA-17cert................................................... 900 20 300
AA-17sum.................................................... 2,100 19 665
AA-17b:
(With assistance)........................................... 250 40 167
(Without assistance)........................................ 20 50 17
AA-19a:
[[Page 8263]]
(Without assistance)........................................ 200 45 150
(Without assistance)........................................ 15 65 16
-----------------------------------------------
Total................................................... 3,485 .............. 1,315
----------------------------------------------------------------------------------------------------------------
2. 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
Forms AA-3cert, Application Summary and Certification, and AA-3sum,
Application Summary.
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 on-line information system generates a summary of the
information that was provided on either Form AA-3cert, Application
Summary and Certification, or Form AA-3sum, Application Summary, for
the applicant to review and approve. Form AA-3cert documents approval
using the traditional pen and ink ``wet'' signature, and Form AA-3sum
documents approval using the alternative signature method called
Attestation. 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.
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 (80 FR 75141 on December 1, 2015) 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 to remove the manual version of
Form AA-3, from the information collection due to receiving less than
10 responses annually.
The burden estimate for the ICR is as follows:
----------------------------------------------------------------------------------------------------------------
Annual Time Burden
Form number responses (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
AA-3 online process:
AA-3cert (with assistance).................................. 4,700 30 2,350
AA-3sum (with assistance)................................... 7,000 29 3,383
-----------------------------------------------
Total................................................... 11,700 .............. 5,733
----------------------------------------------------------------------------------------------------------------
3. Title and Purpose of information collection: Request for
Medicare Payment; OMB 3220-0131.
Under Section 7(d) of the Railroad Retirement Act, the RRB
administers the Medicare program for persons covered by the railroad
retirement system. The collection obtains the information needed by
Palmetto GBA, the Medicare carrier for railroad retirement
beneficiaries, to pay claims for payments under Part B of the Medicare
program. Authority for collecting the information is prescribed in 42
CFR 424.32.
The RRB currently utilizes Forms G-740S, Patient's Request for
Medicare Payment, along with Centers for Medicare & Medicaid Services
Form CMS-1500, to secure the information necessary to pay Part B
Medicare Claims. One response is completed for each claim. Completion
is required to obtain a benefit.
Previous Requests for Comments: The RRB has already published the
initial 60-day notice (80 FR 72998 on November 23, 2015) required by 44
U.S.C. 3506(c)(2). That request elicited no comments.
Information Collection Request (ICR)
Title: Request for Medicare Payment.
OMB Control Number: 3220-0131.
Form(s) submitted: G-740S, CMS-1500.
Type of request: Extension without change of a currently approved
collection.
Affected public: Individuals or Households.
Abstract: The RRB administers the Medicare program for persons
covered by the Railroad Retirement System. The collection obtains the
information needed by Palmetto GBA, the RRB's carrier, to pay claims
for services covered under Part B of the program.
Changes proposed: The RRB proposes no changes to RRB Form G-740S.
The burden estimate for the ICR is as follows:
Estimated annual number of respondents: See Justification (Item No.
12).
[[Page 8264]]
Total annual responses: 1.
Total annual reporting hours: 1.
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. 2016-03328 Filed 2-17-16; 8:45 am]
BILLING CODE 7905-01-P
