Information Collection

Request To Disability Annuitant For Information On Physical Condition And Employment

IC 176775 under ICR 198512-3206-001 · OMB 3206-0143.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	REQUEST TO DISABILITY ANNUITANT FOR INFORMATION ON PHYSICAL CONDITION AND EMPLOYMENT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BRI 80-32				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,000	11,500	4,500
Annual IC Time Burden (Hours)	8,000	5,750	2,250
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.