Agency information collection activities: Submission for OMB review; comment request,

[Federal Register: September 24, 1999 (Volume 64, Number 185)]

[Notices]

[Page 51809]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr24se99-126]

RAILROD RETIREMENT BOARD

Agency Forms Submitted for OMB Review

SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35), the Railroad Retirement Board (RRB) has submitted the following proposal(s) for the collection of information to the Office of Management and Budget for review and approval.

Summary of Proposal(s)

(1) Collection title: Request for Review of Part B Medicare Claim.

(2) Form(s) submitted: G-790, G-791.

(3) OMB Number: 3220-0100.

(4) Expiration date of current OMB clearance: 11/30/1999.

(5) Type of request: Extension of a currently approved collection.

(6) Respondents: Individuals or Households.

(7) Estimated annual number of respondents: 4,000.

(8) Total annual responses: 4,100.

(9) Total annual reporting hours: 1,025.

(10) Collection description: The Railroad Retirement Board administers the Medicare program for persons covered by the Railroad Retirement system. The request provides the means for obtaining reviews by the UnitedHealthcare Insurance company on claims for Part B Medicare benefits.

Additional Information or Comments

Copies of the form and supporting documents can be obtained from Chuck Mierzwa, the agency clearance officer (312-751-3363). Comments regarding the information collection should be addressed to Ronald J. Hodapp, Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois, 60611-2092 and the OMB reviewer, Laurie Schack (202-395- 7316), Office of Management and Budget, Room 10230, New Executive Office Building, Washington, DC 20503. Chuck Mierzwa, Clearance Officer.

[FR Doc. 99-24870Filed9-23-99; 8:45 am]

BILLING CODE 7905-01-M