# Submission for OMB Review; Comment Request for Review of a Revised Information Collection: (OMB Control No. 3206-0179; Form 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. This information collection, “Disabled Dependent Questionnaire” (OMB Control No. 3206-0179; Form RI 30-10), is used to collect sufficient information about the medical condition and earning capacity for the Office of Personnel Management 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 are completed annually. The form takes approximately 1 hour to complete. The annual estimated burden is 2,500 hours.
For copies of this proposal, contact Cyrus S. Benson on (202) 606-4808, FAX (202) 606-0910 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—
James K. Freiert (Acting), Deputy Associate Director, Retirement Operations, Retirement and Benefits, U.S. Office of Personnel Management, 1900 E Street, NW., Room 3305, Washington, DC 20415-3500 and
OPM Desk Officer, Office of Information & Regulatory Affairs, Office of Management and Budget, New Executive Office Building, NW., 725 17th Street, NW., Room 10235, Washington, DC 20503.
*For information regarding administrative coordination contact:* Cyrus S. Benson, Team Leader, Publications Team, R&B/Resource Management/Support Group, U.S. Office of Personnel Management, 1900 E Street, NW., Room 4H28, Washington, DC 20415, (202) 606-4808.
U.S. Office of Personnel Management
John Berry,
Director.