Submission for OMB Emergency Clearance of the Revised Information Collections: OPM 2809-EZ1 & OPM 2809-EZ2

Samenvatting

In accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104-13, May 22, 1995), this notice announces that the Office of Personnel Management has submitted to the Office of Management and Budget a request for emergency clearance of the revised information collections: OPM 2809-EZ1 & OPM 2809-EZ2. OPM 2809 EZ1, Enrollment Change and Brochure Request & OPM 2809-EZ2, Open Season HB Enrollment Change, are used by annuitants, survivor annuitants, and former spouses of retirees during Open Season to request an enrollment change, insurance plan brochures, and other informational materials. If OPM Form 2809-EZ1 is used to request plan brochures, an OPM Form 2809-EZ2 is furnished to the enrollee for use if a plan change is desired. Approximately 74,200 OPM Forms 2809-EZ1 are completed annually. Each form requires approximately 30 minutes to complete. The annual burden is 37,100 hours. Approximately 35,345 OPM Forms 2809-EZ2 are completed annually. Each form requires approximately 30 minutes to complete. The annual burden is 17,672 hours. For copies of this proposal, contact Jim Farron on (202) 418-3208, or E-mail to [email protected]