Federal Register: November 15, 2004 (Volume 69, Number 219)
DOCID: FR Doc 04-25290
RAILROAD RETIREMENT BOARD
Railroad Retirement Board
NOTICE: NOTICES
SUBJECT CATEGORY:
Agency Forms Submitted for OMB Review
DOCUMENT SUMMARY:
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: Report of Medicaid State Office on Beneficiary's BuyInStatus.
(2) Form(s) submitted: RL380F.
(3) OMB Number: 32200185.
(4) Expiration date of current OMB clearance: 02/28/2005.
(5) Type of request: Extension of a currently approved collection. (6) Respondents: State, local or tribal government.
(7) Estimated annual number of respondents: 600.
(8) Total annual responses: 600.
(9) Total annual reporting hours: 100.
(10) Collection description: Under the Railroad Retirement Act, the
Railroad Retirement Board administers the Medicare program for persons
covered by the railroad retirement system. The collection obtains the
information needed to determine if certain railroad beneficiaries are
entitled to receive Supplementary Medical Insurance program coverage
under a state buyin agreement in states in which they reside. Additional Information or Comments
Copies of the forms and supporting documents can be obtained from Charles Mierzwa, the agency clearance officer (3127513363).
Comments regarding the information collection should be addressed
to Ronald J. Hodapp, Railroad Retirement Board, 844 North Rush Street,
Chicago, Illinois, 606112092 and to the OMB Desk Officer for the RRB,
at the Office of Management and Budget, Room 10230, New Executive Office Building, Washington, DC 20503.
Charles Mierzwa,
Clearance Officer.
[FR Doc. 0425290 Filed 111204; 8:45 am]
BILLING CODE 790501P
SUMMARY:
Agency information collection activities; proposals, submissions, and approvals,
DOCUMENT BODY 2:
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: Report of Medicaid State Office on Beneficiary's BuyInStatus.
(2) Form(s) submitted: RL380F.
(3) OMB Number: 32200185.
(4) Expiration date of current OMB clearance: 02/28/2005.
(5) Type of request: Extension of a currently approved collection. (6) Respondents: State, local or tribal government.
(7) Estimated annual number of respondents: 600.
(8) Total annual responses: 600.
(9) Total annual reporting hours: 100.
(10) Collection description: Under the Railroad Retirement Act, the
Railroad Retirement Board administers the Medicare program for persons
covered by the railroad retirement system. The collection obtains the
information needed to determine if certain railroad beneficiaries are
entitled to receive Supplementary Medical Insurance program coverage
under a state buyin agreement in states in which they reside. Additional Information or Comments
Copies of the forms and supporting documents can be obtained from Charles Mierzwa, the agency clearance officer (3127513363).
Comments regarding the information collection should be addressed
to Ronald J. Hodapp, Railroad Retirement Board, 844 North Rush Street,
Chicago, Illinois, 606112092 and to the OMB Desk Officer for the RRB,
at the Office of Management and Budget, Room 10230, New Executive Office Building, Washington, DC 20503.
Charles Mierzwa,
Clearance Officer.
[FR Doc. 0425290 Filed 111204; 8:45 am]
BILLING CODE 790501P