Agency Forms Submitted for OMB Review, Request for Comments, 8262-8264 [2016-03328]

Download as PDF 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 (http://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: VerDate Sep<11>2014 19:03 Feb 17, 2016 Jkt 238001 PO 00000 Frm 00090 Fmt 4703 Sfmt 4703 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 18FEN1 8264 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 VerDate Sep<11>2014 19:03 Feb 17, 2016 Jkt 238001 PO 00000 Frm 00092 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 E:\FR\FM\18FEN1.SGM 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]


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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