[Federal Register: July 21, 2005 (Volume 70, Number 139)]
[Notices]               
[Page 42113]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr21jy05-147]                         

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OFFICE OF PERSONNEL MANAGEMENT

 
Submission for OMB Review; Comment Request for Review of a 
Revised Information Collection: RI 78-11

AGENCY: Office of Personnel Management.

ACTION: Notice.

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SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Pub. 
L. 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management (OPM) has submitted to the Office of Management 
and Budget a request for review of a revised information collection. RI 
78-11, Medicare Part B Certification, collects information from 
annuitants, their spouses, and survivor annuitants to determine their 
eligibility under the Retired Federal Employees Health Benefits Program 
for a Government contribution toward the cost of Part B of Medicare.
    Approximately 100 RI 78-11 forms are completed annually. Each form 
requires approximately 10 minutes complete. The annual estimated burden 
is 17 hours.
    For copies of this proposal, contact Mary Beth Smith-Toomey on 
(202) 606-8358, FAX (202) 418-3251 or via e-mail to mbtoomey@opm.gov. 
Please include a mailing address with your request.

DATES: Comments on this proposal should be received within 30 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to--
    Pamela S. Israel, Chief, Operations Support Group, Retirement 
Services Programs, U.S. Office of Personnel Management, 1900 E Street, 
NW., Room 3349, Washington, DC 20415; and
    Brenda Aguilar, OPM Desk Officer, Office of Information and 
Regulatory Affairs, Office of Management and Budget, New Executive 
Office Building, NW., Room 10235, Washington, DC 20503.

FOR FURTHER INFORMATION CONTACT: Cyrus S. Benson, Team Leader, 
Publications Team, RIS Support Services/Support Group, (202) 606-0623.

Office of Personnel Management.
Linda M. Springer,
Director.
[FR Doc. 05-14239 Filed 7-20-05; 8:45 am]
BILLING CODE 6325-38-P