81 FR 8262 - Agency Forms Submitted for OMB Review, Request for Comments
RAILROAD RETIREMENT BOARD Federal Register Volume 81, Issue 32 (February 18, 2016)
Federal Register Volume 81, Issue 32 (February 18, 2016)
| Page Range | 8262-8264 | |
| FR Document | 2016-03328 |
[Federal Register Volume 81, Number 32 (Thursday, February 18, 2016)] [Notices] [Pages 8262-8264] From the Federal Register Online [www.thefederalregister.org] [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 [email protected]. Comments regarding the information collection should be addressed to Charles Mierzwa, Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois, 60611-2092 or [email protected] and to the OMB Desk Officer for the RRB, Fax: 202-395-6974, Email address: [email protected]. Charles Mierzwa, Chief of Information Resources Management. [FR Doc. 2016-03328 Filed 2-17-16; 8:45 am] BILLING CODE 7905-01-P
![8262 Federal Register / Vol. 81, No. 32 / Thursday, February 18, 2016 / Notices
CFR part 3020, subpart B. Comments are subject of collection; and (4) ways to provided on either Form AA–17cert,
due no later than February 19, 2016. minimize the burden of collections on Application Summary and Certification,
The public portions of these filings can respondents, including the use of or Form AA–17sum, Application
be accessed via the Commission’s Web automated collection techniques or Summary, for the applicant to review
site (http://www.prc.gov). other forms of information technology. and approve. Form AA–17cert
The Commission appoints Kenneth R. Comments to the RRB or OIRA must documents approval using the
Moeller to represent the interests of the contain the OMB control number of the traditional pen and ink ‘‘wet’’ signature,
general public (Public Representative) ICR. For proper consideration of your and Form AA–17sum, documents
in this docket. comments, it is best if the RRB and approval using the alternative signature
OIRA receive them within 30 days of method called Attestation. When the
III. Ordering Paragraphs
the publication date. RRB representative is unable to contact
It is ordered: 1. Title and purpose of information the applicant in person or by telephone,
1. The Commission reopens Docket collection: Application for Survivor for example, the applicant lives in
No. CP2015–43 for consideration of Insurance Annuities; OMB 3220–0030. another country, a manual version of
matters raised by the Postal Service’s Under Section 2(d) of the Railroad Form AA–17 is used.
Notice. Retirement Act (RRA), monthly survivor One response is requested of each
2. Pursuant to 39 U.S.C. 505, the annuities are payable to surviving respondent. Completion of the forms is
Commission appoints Kenneth R. widow(er)s, parents, unmarried required to obtain a benefit.
Moeller to serve as an officer of the children, and in certain cases, divorced Previous Requests for Comments: The
Commission (Public Representative) to spouses, mothers (fathers), remarried RRB has already published the initial
represent the interests of the general widow(er)s, and grandchildren of 60-day notice (80 FR 75140 on
public in this proceeding. deceased railroad employees if there are December 1, 2015) required by 44 U.S.C.
3. Comments are due no later than no qualified survivors of the employee 3506(c)(2). That request elicited no
February 19, 2016. immediately eligible for an annuity. The
4. The Secretary shall arrange for comments.
requirements relating to the annuities
publication of this order in the Federal are prescribed in 20 CFR 216, 217, 218, Information Collection Request (ICR)
Register. and 219. Title: Application for Survivor
By the Commission. To collect the information needed to Insurance Annuities.
Stacy L. Ruble, help determine an applicant’s OMB Control Number: 3220–0030.
Secretary. entitlement to, and the amount of, a
Form(s) submitted: AA–17, AA–17b,
survivor annuity the RRB uses Forms
[FR Doc. 2016–03281 Filed 2–17–16; 8:45 am] AA–17cert, AA–17sum, AA–18, AA–19,
AA–17, Application for Widow(er)’s
BILLING CODE 7710–FW–P AA–19a, and AA–20.
Annuity; AA–17b, Applications for
Determination of Widow(er)’s Disability; Type of request: Revision of a
AA–18, Application for Mother’s/ currently approved collection.
RAILROAD RETIREMENT BOARD Father’s and Child’s Annuity; AA–19, Affected public: Individuals or
Application for Child’s Annuity; AA– Households.
Agency Forms Submitted for OMB Abstract: Under Section 2(d) of the
Review, Request for Comments 19a, Application for Determination of
Child’s Disability; AA–20, Application Railroad Retirement Act, monthly
SUMMARY: In accordance with the for Parent’s Annuity, and electronic survivor annuities are payable to
Paperwork Reduction Act of 1995 (44 Forms AA–17cert, Application surviving widow(er)s, parents,
U.S.C. Chapter 35), the Railroad Summary and Certification, and AA– unmarried children, and in certain
Retirement Board (RRB) is forwarding 17sum, Application Summary. cases, divorced wives (husbands),
three Information Collection Requests The AA–17 application process mothers (fathers), remarried widow(er)s
(ICR) to the Office of Information and obtains information from an applicant and grandchildren of deceased railroad
Regulatory Affairs (OIRA), Office of about their marital history, work employees. The collection obtains
Management and Budget (OMB). Our history, benefits from other government information needed by the RRB to
ICR describes the information we seek agencies, and Medicare entitlement for determine entitlement to and the
to collect from the public. Review and a survivor annuity. An RRB amount of the annuity applied for.
approval by OIRA ensures that we representative interviews the applicant Changes proposed: The RRB proposes
impose appropriate paperwork burdens. either at a field office (preferred), an to remove the manual version of Forms
The RRB invites comments on the itinerant point, or by telephone. During AA–17, AA–18, AA–19 and AA–20
proposed collections of information to the interview, the RRB representative from the information collection due to
determine (1) the practical utility of the enters the information obtained into an receiving less than 10 responses
collections; (2) the accuracy of the on-line information system. Upon annually. No changes are proposed to
estimated burden of the collections; (3) completion of the interview, the on-line Forms AA–17b and AA–19a.
ways to enhance the quality, utility, and information system generates a The burden estimate for the ICR is as
clarity of the information that is the summary of the information that was follows:
Annual Time Burden
Form number responses (minutes) (hours)
mstockstill on DSK4VPTVN1PROD with NOTICES
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:
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![8264 Federal Register / Vol. 81, No. 32 / Thursday, February 18, 2016 / Notices
Total annual responses: 1. Securities and Exchange Commission the old security, without the consent of
Total annual reporting hours: 1. (‘‘Commission’’), pursuant to Section the Party that released the symbol. In
Additional Information or Comments: 11A of the Securities Exchange Act of addition, a Party may not reuse (or
Copies of the forms and supporting 1934 (‘‘Act’’) 1 and Rule 608 consent to the reuse of) a symbol to
documents can be obtained from Dana thereunder,2 a proposal to amend the identify a new security unless such
Hickman at (312) 751–4981 or Plan.3 The proposal represents the third Party reasonably determines that such
Dana.Hickman@RRB.GOV. substantive amendment to the Plan use would not cause investor confusion.
Comments regarding the information (‘‘Amendment’’) and reflects changes The Commission is publishing this
collection should be addressed to unanimously approved by the Parties.4 notice to solicit comments from
Charles Mierzwa, Railroad Retirement The Amendment to the Plan proposes to interested persons on the Amendment
Board, 844 North Rush Street, Chicago, revise Section IV(d) of the Plan (Reuse to the Plan.5
Illinois, 60611–2092 or of a Symbol) to provide that, where a
Charles.Mierzwa@RRB.GOV and to the I. Description and Purpose of the
Party ceases to use a symbol, such party
OMB Desk Officer for the RRB, Fax: Amendment
may elect to release the symbol and that
202–395–6974, Email address: OIRA_ such symbol may not be reused to The Plan was created to enhance the
Submission@omb.eop.gov. identify a new security (other than the effectiveness and efficiency of the
security that has been trading under national market system and to provide
Charles Mierzwa,
such symbol) within 90 calendar days for fair competition between the self-
Chief of Information Resources Management.
from the last day of its use to identify regulatory organizations (‘‘SROs’’) by
[FR Doc. 2016–03328 Filed 2–17–16; 8:45 am] establishing a uniform system for the
BILLING CODE 7905–01–P 1 15 selection and reservation of securities
U.S.C. 78k–1.
2 17 CFR 242.608. symbols. The Plan, among other things,
3 The Plan provides an orderly process for Parties
sets forth the process for securing
SECURITIES AND EXCHANGE to reserve available ticker symbols for equity perpetual and limited-time reservations,
COMMISSION securities. Specifically, each party to the Plan may
reserve a set number of 1-, 2-, or 3-character the use of a waiting list, the right to
[Release No. 34–77123; File No. 4–533] symbols and a set number of 4- or 5-character reuse a symbol and the ability to request
symbols. In the case of 1-, 2-, or 3-character the release of a symbol.
symbols, each party may reserve up to 20 symbols Under Section IV(d) of the current
Joint Industry Plan; Notice of Filing of perpetually (i.e., without a time limit on the
Amendment No. 3 to the National reservation) as ‘‘List A reservations,’’ and 1,500
Plan, if a Party ceases to use a symbol,
Market System Plan for the Selection symbols for 24 months (i.e., with a 24-month such Party automatically has that
and Reservation of Securities Symbols expiration on the reservation) as ‘‘List B symbol reserved for a period of 24
Submitted by Financial Industry reservations.’’ Each party also may reserve the same months, notwithstanding any other
number of symbols on a separate ‘‘List A’’ and a limits on the number of reserved
Regulatory Authority, Inc., BATS separate ‘‘List B’’ for 4- or 5-character symbols.
Exchange, Inc., BOX Options 4 On November 6, 2008, the Commission symbols specified in the Plan.6
Exchange, LLC, Chicago Board approved the Symbology Plan that was originally However, in the event that the Party
Options Exchange, Incorporated, proposed by the CHX, Nasdaq, FINRA, NSX, and ceasing to use the symbol neither: (1)
Phlx, subject to certain changes. See Securities Places the symbol on its List A, or (2)
Chicago Stock Exchange, Inc., EDGA Exchange Act Release No. 58904, 73 FR 67218
Exchange, Inc., EDGX Exchange, Inc., (November 13, 2008) (File No. 4–533). On
uses the symbol within 24 months, the
International Securities Exchange, November 18, 2008, the ISE, and on December 22, symbol is released for use pursuant to
LLC, NASDAQ OMX BX, Inc., NASDAQ 2008, NYSE, NYSE Arca, NYSE MKT (f/k/a ‘‘NYSE Section IV(b)(5) (Non-Use or Release of
Alternext US, LLC’’) and CBOE, and on December Symbols Within Time Period). In such
OMX PHLX, Inc., The Nasdaq Stock 24, 2008, NASDAQ OMX BX, filed amendments to
Market LLC, National Stock Exchange, join the Plan, which amendments became
cases, the symbol may be reused by a
Inc., New York Stock Exchange, LLC, immediately effective upon filing. See Securities different Party to identify a new security
NYSE MKT, LLC, and NYSE Arca, Inc. Exchange Act Release No. 59024 (November 26, in accordance with the procedures set
2008), 73 FR 74538 (December 8, 2008) (File No. forth in the Plan. Section IV(d) of the
February 11, 2016. 4–533) (ISE filing to join the Plan); Securities
Exchange Act Release No. 59162 (December 24,
Plan provides that a symbol may not be
On August 24, 2015, Financial 2008), 74 FR 132 (January 2, 2009) (File No. 4–533) reused by a Party to identify a new
Industry Regulatory Authority, Inc. (NYSE, NYSE Arca, NYSE Alternext US LLC and security unless the Party reasonably
(‘‘FINRA’’), on behalf of the following CBOE filing to join the Plan); and Securities determines that such use would not
parties to the National Market System Exchange Act Release No. 59187 (December 30,
2008), 74 FR 729 (January 7, 2009) (File No. 4–533)
cause investor confusion. Thus, even
Plan for the Selection and Reservation (NASDAQ OMX BX filing to join the Plan). On where a Party releases a symbol for
of Securities Symbols (the ‘‘Plan’’): January 5, 2009 and March 6, 2009, the Parties reuse, such symbol may not be reused
BATS Exchange, Inc. (‘‘BATS’’), BOX amended the plan to modify certain effective dates to identify a new security if such use
Options Exchange, LLC (‘‘BOX’’), in the Plan, which amendments became
immediately effective upon filing. See Securities
would cause investor confusion in the
Chicago Board Options Exchange, Exchange Act Release No. 59225 (January 9, 2009), judgment of the party seeking to reuse
Incorporated (‘‘CBOE’’), Chicago Stock 73 FR 3117 (January 16, 2009) (File No. 4–533) the symbol.
Exchange, Inc. (‘‘CHX’’), EDGA (Amendment No. 1); and Securities Exchange Act The Parties are amending Section
Exchange, Inc. (‘‘EDGA’’), EDGX Release No. 59574 (March 13, 2009), 74 FR 11981
(March 20, 2009) (File No. 4–533) (Amendment No.
IV(d) of the Plan to clarify that, if a Party
Exchange, Inc. (‘‘EDGX’’), FINRA, 2). On September 30, 2009, BATS, on July 7, 2010, ceases use of a symbol, such Party may
International Securities Exchange, LLC EDGA and EDGX, and on May 7, 2012, BOX, filed elect to release the symbol pursuant to
(‘‘ISE’’), NASDAQ OMX BX, Inc. amendments to join the Plan, which amendments paragraph (b)(5) of the Plan. If a Party
became immediately effective upon filing. See
mstockstill on DSK4VPTVN1PROD with NOTICES
(‘‘BX’’), NASDAQ OMX PHLX, Inc. does not release the symbol, such
Securities Exchange Act Release No. 60856 (October
(‘‘Phlx’’), The Nasdaq Stock Market LLC 21, 2009), 74 FR 55276 (October 27, 2009) (File No.
(‘‘Nasdaq’’), National Stock Exchange, 4–533) (BATS filing to join the Plan); Securities 5 17 CFR 242.608(b)(1).
Inc. (‘‘NSX’’), New York Stock Exchange Act Release No. 62573 (July 26, 2010), 75 6 Except that, pursuant to paragraph (f) of Section
Exchange, LLC (‘‘NYSE’’), NYSE MKT, FR 45682 (August 3, 2010) (File No. 4–533) (EDGA IV (Portability of Symbols in Use), if a new SRO
and EDGX filing to join the Plan); and Securities lists a security or product that previously was listed
LLC (‘‘NYSE MKT’’), and NYSE Arca, Exchange Act Release No. 66957 (May 10, 2012), 77 on another SRO, the new SRO has the right to that
Inc. (‘‘NYSE Arca’’) (collectively with FR 28904 (May 16, 2012) (File No. 4–533) (BOX symbol unless, in its discretion, it consents to the
FINRA, the ‘‘Parties’’), filed with the filing to join the Plan). symbol being retained by the former SRO.
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Document Created: 2016-02-18 07:46:09
Document Modified: 2016-02-18 07:46:09
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| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
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| FR Citation | 81 FR 8262 |
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