6380 Federal Register / Vol. 86, No. 12 / Thursday, January 21, 2021 / Notices 

j. To an official of another Federal 

agency, information needed in the 

performance of official duties related to 

reconciling or reconstructing data files; 

compiling descriptive statistics; and/or 

making analytical studies to support the 

function for which the records were 

collected and maintained. 

k. To a spouse or dependent child (or 

court-appointed guardian thereof) of an 

FEHB enrollee whether the enrollee has 

made enrollment changes, including 

changing FEHB plans; cancelling or 

suspending FEHB enrollment; and 

changing from a Self and Family to a 

Self Plus One or Self Only health 

benefits enrollment, or from a Self Plus 

One to Self Only health benefits 

enrollment. 

l. To provide an official of another 

Federal agency information needed in 

the performance of official duties 

related to federal employee health 

benefits counseling, customer service, or 

operational readiness. 

m. To the following recipients, 

information needed to conduct an 

analytical study of benefits being paid 

under the FEHB Program or the 

recipient’s benefits program(s): Federal, 

State, or local agencies. 

n. To the following recipients, 

information needed to adjudicate a 

claim for benefits under the FEHB 

Program or the recipient’s benefits 

program(s): Federal, State, local, or 

agencies. 

o. To another Federal or non-Federal 

entity, information needed to verify 

enrollment information through the use 

of computer matching agreements under 

the Privacy Act of 1974, as amended (5 

U.S.C. 552a). 

POLICIES AND PRACTICES FOR STORAGE OF

RECORDS: 

These records in this system of 

records are stored electronically on 

OPM’s servers hosted at an OPM data 

center and at the U.S. Department of 

Agriculture’s National Finance Center. 

Access to the electronic systems is 

restricted to authorized users with a 

need to know. 

POLICIES AND PRACTICES FOR RETRIEVAL OF

RECORDS: 

These records in this system of 

records are retrieved primarily by name 

and Social Security number, but may be 

retrieved by any personal identifier. 

POLICIES AND PRACTICES FOR RETENTION AND

DISPOSAL OF RECORDS: 

A records retention schedule will be 

established with NARA for the records 

about covered individuals in this system 

of records and, until it is finalized, 

records will be treated as permanent. 

Once that schedule is established, the 

method(s) for disposing of records that 

are no longer be eligible for retention 

will be established. 

ADMINISTRATIVE, TECHNICAL, AND PHYSICAL

SAFEGUARDS: 

Records in this system are protected 

from unauthorized access and misuse 

through various administrative, 

technical and physical security 

measures. OPM security measures are in 

compliance with the Federal 

Information Security Modernization Act 

of 2014 (Pub. L. 113–203), associated 

OMB policies, and applicable standards 

and guidance from the National Institute 

of Standards and Technology (NIST). 

RECORD ACCESS PROCEDURES: 

Individuals seeking notification of 

and access to their records in this 

system of records may do so by 

submitting a request in writing to the 

Office of Personnel Management, Office 

of Privacy and Information 

Management—FOIA, 1900 E Street NW, 

Washington, DC 20415–7900 or by 

emailing foia@opm.gov; ATTN: 

Healthcare and Insurance. Individuals 

must furnish the following information 

for their records to be located: 

1. Full name, including any former 

name. 

2. Date of birth. 

3. Social Security Number. 

4. Name and address of employing 

agency or retirement system. 

5. Reasonable specification of the 

requested information. 

6. The address to which the 

information should be sent. 

7. Signature. 

Individuals requesting access must 

also comply with OPM’s Privacy Act 

regulations regarding verification of 

identity and access to records (5 CFR 

297). 

Enrollees who request access to their 

records will have access to the entirety 

of their record, to include information 

about all covered individuals who are 

part of their enrollment record. Family 

members of the enrollee who request 

access to their records may have access 

only to their own information and not 

to that of the enrollee or other covered 

family members. 

CONTESTING RECORD PROCEDURES: 

Individuals wishing to request 

amendment of records about them may 

do so by writing to the Office of 

Personnel Management, Office of 

Privacy and Information Management— 

FOIA, 1900 E Street NW, Washington, 

DC 20415–7900 or by emailing foia@

opm.gov; ATTN: Healthcare and 

Insurance. Requests for amendment of 

records should include the words 

‘‘PRIVACY ACT AMENDMENT 

REQUEST’’ in capital letters at the top 

of the request letter; if emailed include 

those words in the subject line. 

Individuals must furnish the following 

information for their records to be 

located: 

1. Full name, including any former 

name, and address. 

2. Date of birth. 

3. Social Security Number. 

4. Name and address of employing 

agency or retirement system. 

5. Precise identification of the 

information to be amended. 

6. Signature. 

Individuals requesting amendment 

must also comply with OPM’s Privacy 

Act regulations regarding verification of 

identity and access to records (5 CFR 

297). 

OPM may refer amendment requests 

to employing agencies, retirement 

systems, and FEHB Carriers because 

they may be the ultimate source of 

FEHB enrollment records. 

NOTIFICATION PROCEDURES: 

See ‘‘Record Access Procedure.’’ 

EXEMPTIONS PROMULGATED FOR THE SYSTEM: 

None. 

HISTORY: 

OPM/Central–1, ‘‘Civil Service 

Retirement and Insurance Records’’, 73 

FR 15013 (March 20, 2008), 80 FR 74815 

(November 30, 2015). 

[FR Doc. 2021–01259 Filed 1–19–21; 8:45 am] 

BILLING CODE 6325–XX–P 

OFFICE OF PERSONNEL 

MANAGEMENT 

Submission for Review: 3206–0140, 

Representative Payee Application (RI 

20–7) and Information Necessary for a 

Competency Determination (RI 30–3) 

AGENCY: Office of Personnel 

Management. 

ACTION: 30-Day notice and request for 

comments. 

SUMMARY: Retirement Services, Office of 

Personnel Management (OPM) offers the 

general public and other federal 

agencies the opportunity to comment on 

a revised information collection request 

(ICR), RI 20–7 [Representative Payee 

Application] and RI 30–3 [Information 

for a Competency Determination]. 

DATES: Comments are encouraged and 

will be accepted until February 22, 

2021. 

ADDRESSES: Interested persons are 

invited to submit written comments on 

the proposed information collection to 


jbell on DSKJLSW7X2PROD with NOTICES
Federal Register / Vol. 86, No. 12 / Thursday, January 21, 2021 / Notices 6381 

the Office of Information and Regulatory 

Affairs, Office of Management and 

Budget, 725 17th Street NW, 

Washington, DC 20503, Attention: Desk 

Officer for the Office of Personnel 

Management or sent via electronic mail 

to: oira_submission@omb.eop.gov or 

faxed to (202) 395–6974.. 

FOR FURTHER INFORMATION CONTACT: A 

copy of this ICR with applicable 

supporting documentation, may be 

obtained by contacting the Retirement 

Services Publications Team, Office of 

Personnel Management, 1900 E Street 

NW, Room 3316–L, Washington, DC 

20415, Attention: Cyrus S. Benson, or 

sent via electronic mail to 

Cyrus.Benson@opm.gov or faxed to 

(202) 606–0910 or via telephone at (202) 

606–4808. 

SUPPLEMENTARY INFORMATION: As 

required by the Paperwork Reduction 

Act of 1995 OPM is soliciting comments 

for this collection. The information 

collection (OMB No. 3206–0140) was 

previously published in the Federal 

Register on April 13, 2020 at 85 FR 

20532, allowing for a 60-day public 

comment period. No comments were 

received. The Office of Management and 

Budget is particularly interested in 

comments that: 

1. Evaluate whether the proposed 

collection of information is necessary 

for the proper performance of functions 

of the agency, including whether the 

information will have practical utility; 

2. Evaluate the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information, 

including the validity of the 

methodology and assumptions used; 

3. Enhance the quality, utility, and 

clarity of the information to be 

collected; and 

4. Minimize the burden of the 

collection of information on those who 

are to respond, including through the 

use of appropriate automated, 

electronic, mechanical, or other 

technological collection techniques or 

other forms of information technology, 

e.g., permitting electronic submissions 

of responses. 

Form RI 20–7 is used by the Civil 

Service Retirement System (CSRS) and 

the Federal Employees Retirement 

System (FERS) to collect information 

from persons who apply to be 

fiduciaries for annuitants or survivor 

annuitants who appear to be incapable 

of handling their own funds or for 

minor children. RI 30–3 is an enclosure 

to RI 20–7 and is needed for adult 

annuitants who are alleged to be 

incompetent. RI 30–3 collects medical 

information regarding the annuitant’s 

competency for OPM’s use in evaluating 

the annuitant’s condition. 

Analysis 

Agency: Retirement Operations, 

Retirement Services, Office of Personnel 

Management. 

Title: Annuity Supplement Earnings 

Report. 

OMB Number: 3206–0140. 

Frequency: On occasion. 

Affected Public: Individuals or 

Households. 

Number of Respondents: 12,480 [RI 

20–7] and 250 [RI 30–3]. 

Estimated Time per Respondent: 30 

minutes [RI 20–7] and 1 hour [RI 30–3]. 

Total Burden Hours: 6,240 [RI 20–7] 

and 250 [RI 30–3]. 

Office of Personnel Management. 

Alexys Stanley, 

Regulatory Affairs Analyst. 

[FR Doc. 2021–01248 Filed 1–19–21; 8:45 am] 

BILLING CODE 6325–38–P 

OFFICE OF PERSONNEL 

MANAGEMENT 

Submission for Review: 3206–0128, 

Application for Refund of Retirement 

Deductions (CSRS)—SF 2802 and 

Current/Former Spouse’s Notification 

for Refund of Retirement Deductions 

Under CSRS—SF 2802A 

AGENCY: Office of Personnel 

Management. 

ACTION: 30-Day notice and request for 

comments. 

SUMMARY: Retirement Services, Office of 

Personnel Management (OPM) offers the 

general public and other federal 

agencies the opportunity to comment on 

a revised information collection request 

(ICR), SF 2802 [Application for Refund 

of Retirement Deductions: CSRS] and SF 

2802A [Notification of Application for 

Refund of Retirement Deductions Under 

CSRS]. 

DATES: Comments are encouraged and 

will be accepted until February 22, 

2021. 

ADDRESSES: Interested persons are 

invited to submit written comments on 

the proposed information collection to 

the Office of Information and Regulatory 

Affairs, Office of Management and 

Budget, 725 17th Street NW, 

Washington, DC 20503, Attention: Desk 

Officer for the Office of Personnel 

Management or sent via electronic mail 

to: oira_submission@omb.eop.gov or 

faxed to (202) 395–6974.. 

FOR FURTHER INFORMATION CONTACT: A 

copy of this ICR with applicable 

supporting documentation, may be 

obtained by contacting the Retirement 

Services Publications Team, Office of 

Personnel Management, 1900 E Street 

NW, Room 3316–L, Washington, DC 

20415, Attention: Cyrus S. Benson, or 

sent via electronic mail to 

Cyrus.Benson@opm.gov or faxed to 

(202) 606–0910 or via telephone at (202) 

606–4808. 

SUPPLEMENTARY INFORMATION: As 

required by the Paperwork Reduction 

Act of 1995 OPM is soliciting comments 

for this collection. The information 

collection (OMB No. 3206–0128) was 

previously published in the Federal 

Register on June 1, 2020 at 85 FR 33206, 

allowing for a 60-day public comment 

period. No comments were received. 

The Office of Management and Budget 

is particularly interested in comments 

that: 

1. Evaluate whether the proposed 

collection of information is necessary 

for the proper performance of functions 

of the agency, including whether the 

information will have practical utility; 

2. Evaluate the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information, 

including the validity of the 

methodology and assumptions used; 

3. Enhance the quality, utility, and 

clarity of the information to be 

collected; and 

4. Minimize the burden of the 

collection of information on those who 

are to respond, including through the 

use of appropriate automated, 

electronic, mechanical, or other 

technological collection techniques or 

other forms of information technology, 

e.g., permitting electronic submissions 

of responses. 

Standard Form 2802 is used to 

support the payment of monies from the 

Retirement Fund. It identifies the 

applicant for refund of retirement 

deductions. Standard Form 2802A is 

used to comply with the legal 

requirement that any spouse or former 

spouse of the applicant has been 

notified that the former employee is 

applying for a refund. 

Analysis 

Agency: Retirement Operations, 

Retirement Services, Office of Personnel 

Management. 

Title: Application for Refund of 

Retirement Deductions (CSRS) and 

Current/Former Spouse’s Notification of 

Application for Refund of Retirement 

Deductions under CSRS. 

OMB Number: 3206–0128. 

Frequency: On occasion. 

Affected Public: Individuals or 

Households. 

Number of Respondents: 3,741 [SF 

2802] and 3,389 [SF 2802A]. 


jbell on DSKJLSW7X2PROD with NOTICES