THIS REQUEST IS
APPROVED UNTIL FEBRUARY 28, 1983. RRB MUST PROVIDE OMB WITH A
REPORT OF THE RESULTS OF THE SELF-ADMINISTERED APPLICATIONS PILOT
TEST BY JANUARY 1, 1983. RRB MUST PROVIDE OMB WITH ADDITIONAL
JUSTIFICATION FOR THE INCREASE IN AVERAGE RESPONSE TIME FOR THE
APPROVED REVISIONS AS STAFF ESTIMATES WILL NOT BE SUFFICIENT
JUSTIFICATION FOR CHANGES IN BURDEN. IN ADDITION, RRB WILL REMOVE
THE ITEMS RREQUESTING THE RAILROAD EMPLOYEE'S NAME AND CLAIM NUMBER
FROM T FORM THAT REQUEST PUBLICATIONS AND FORMS.
Inventory as of this Action
Requested
Previously Approved
02/28/1983
02/28/1983
04/30/1982
24,450
0
43,800
7,356
0
9,710
0
0
0
THE APPLICATIONS OBTAIN INFORMATION
FROM WIDOW(ER)S, CHILDREN AND PARENTS OF DECEASED RAILROAD WORKERS
TO SUPPORT CLAIMS FOR SURVIVOR BENEFITS. THE INFORMATION WILL BE
USED FOR DETERMINING ENTITLEMENT TO AND AMOUNT OF ANNUITY APPLIED
FOR.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.