# Submission for OMB Review; Comment Request for Review of a Revised Information Collection: RI 30-10
**AGENCY:**
Office of Personnel Management.
**ACTION:**
Notice.
**SUMMARY:**
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 (OPM) has submitted to the Office of Management and Budget (OMB) a request for review of a revised information collection. RI 30-10, Disabled Dependent Questionnaire, is used to collect sufficient information about the medical condition and earning capacity for OPM to be able to determine whether a disabled adult child is eligible for health benefits coverage and/or survivor annuity payments under the Civil Service Retirement System or the Federal Employees' Retirement System.
Approximately 2,500 RI 30-10 forms will be completed annually. The form takes approximately one hour to complete. The annual burden is 2,500 hours.
For copies of this proposal, contact Mary Beth Smith-Toomey on (202) 606-8358, FAX (202) 418-3251 or via e-mail to *[email protected]* . Please include a mailing address with your request.
**DATES:**
Comments on this proposal should be received within 30 calendar days from the date of this publication.
**ADDRESSES:**
Send or deliver comments to—Ronald W. Melton, Deputy Assistant Director, Retirement Services Program, Center for Retirement and Insurance Services, U.S. Office of Personnel Management, 1900 E Street, NW., Room 3305, Washington, DC 20415-3540; and Joseph Lackey, OPM Desk Officer, Officeof Information & Regulatory Affairs, Office of Management and Budget, New Executive Office Building, NW., Room 10235, Washington, DC 20503.
**For Information Regarding Administrative Coordination—Contact:**
Cyrus S. Benson, Team Leader, RIS Support Services/Support Group, Publications Team, (202) 606-0623.
Office of Personnel Management.
Kay Coles James,
Director.