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Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION OF DISABILITY RETIREMENT UNDER FERS, SF 3106 A-E

ICR 198706-3206-005 · OMB 3206-0171 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
157025 APPLICATION OF DISABILITY RETIREMENT UNDER FERS, SF 3106 A-E Form Migrated
ICR Details
3206-0171 198706-3206-005
Historical Active 198704-3206-001
OPM
APPLICATION OF DISABILITY RETIREMENT UNDER FERS, SF 3106 A-E
Extension without change of a currently approved collection   No
Regular
Approved without change 09/21/1987
Retrieve Notice of Action (NOA) 06/23/1987
THIS FORM AND INSTRUCTIONS SHOULD BE PRINTED IDENTICALLY TO THE ONE CURRENTLY IN USE WHICH WAS APPROVED BY OMB IN APRIL 1987. SINCE THE FERS DISABILITY REGULATIONS HAVE NOT AS BEEN ISSUED THE FORM AND INSTRUCTIONS SHOULD CONTINUE TO SHOW NO SPECIFIC CITATIONS TO SECTIONS OF THOSE REGULATIONS.
  Inventory as of this Action Requested Previously Approved
12/31/1987 12/31/1987 07/31/1987
1,000 0 1,000
1,000 0 1,000
0 0 0
THESE DOCUMENTS STIPULATE THE DOCUMENTATION AND ELIGIBILITY REQUIREMENTS FOR DISABILITY RETIREMENT UNDER FERS. ALLOWANCE OR DISALLOWANCE OF DISABILITY RETIREMENT IS BASED UPON INFORMATION PROVIDED IN AND WITH THESE FORMS.
None
None
No
1
IC Title Form No. Form Name
APPLICATION OF DISABILITY RETIREMENT UNDER FERS, SF 3106 A-E SF 3105 A,, B, C, D, E
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,000 1,000 0 0 0 0
Annual Time Burden (Hours) 1,000 1,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/23/1987