[Federal Register Volume 77, Number 55 (Wednesday, March 21, 2012)]
[Notices]
[Pages 16567-16568]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-6783]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for Review: SF 3104, Application for Death Benefits 
Under the Federal Employees Retirement System; and SF 3104B, 
Documentation and Elections in Support of Application for Death 
Benefits When Deceased Was an Employee at the Time of Death

AGENCY: U.S. Office of Personnel Management.

ACTION: 60-Day Notice and request for comments.

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SUMMARY: Retirement Services, Office of Personnel Management (OPM) 
offers the general public and other federal agencies the opportunity to 
comment on a revised information collection request (ICR) 3206-0172, 
Application for Death Benefits under the Federal Employees Retirement 
System and Documentation and Elections in Support of Application for 
Death Benefits When Deceased Was an Employee at the Time of Death. As 
required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 
U.S.C. chapter 35) as amended by the Clinger-Cohen Act (Pub. L. 104-
106), OPM is soliciting comments for this collection. The Office of 
Management and Budget is particularly interested in comments that:
    1. Evaluate whether the proposed collection of information is 
necessary for the proper performance of functions of the agency, 
including whether the information will have practical utility;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected; and
    4. Minimize the burden of the collection of information on those 
who are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses.

DATES: Comments are encouraged and will be accepted until May 21, 2012. 
This process is conducted in accordance with 5 CFR 1320.1.

ADDRESSES: Interested persons are invited to submit written comments on 
the proposed information collection to U.S. Office of Personnel 
Management, Quinta Spear, Deputy Assistant Director, Retirement 
Operations, Retirement Services, 1900 E Street NW., US 300, Washington, 
DC 20415, or sent via electronic mail to [email protected].

FOR FURTHER INFORMATION CONTACT: A copy of this ICR, with applicable 
supporting documentation, may be obtained by contacting the Retirement 
Services Publications Team, Office of Personnel Management, 1900 E 
Street NW., Room 4332, Washington, DC 20415, Attention: Cyrus S. Benson 
or sent via electronic mail to [email protected] or faxed to (202) 
606-0910.

SUPPLEMENTARY INFORMATION: SF 3104, Application for Death Benefits 
under

[[Page 16568]]

the Federal Employees Retirement System, is needed to collect 
information so that OPM can pay death benefits to the survivors of 
Federal employees and annuitants. SF 3104B, Documentation and Elections 
in Support of Application for Death Benefits When Deceased Was an 
Employee at the Time of Death, is needed for deaths in service so that 
survivors can make the needed elections regarding health benefits, 
military service and payment of the death benefit.

Analysis

    Agency: Retirement Operations, Retirement Services, Office of 
Personnel Management
    Title: Application for Death Benefits under the Federal Employees 
Retirement System and Documentation and Elections in Support of 
Application for Death Benefits When Deceased Was an Employee at the 
Time of Death.
    OMB Number: 3206-0172.
    Frequency: On occasion.
    Affected Public: Individuals or Households.
    Number of Respondents: SF 3104 = 12,734 and SF 3104B = 4,017.
    Estimated Time per Respondent: 60 minutes.
    Total Burden Hours: 16,751.

U.S. Office of Personnel Management.
John Berry,
Director.
[FR Doc. 2012-6783 Filed 3-20-12; 8:45 am]
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