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Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATION FOR DEFERRED ANNUITY - SEPARATION BEFORE SEPTEMBER 30, 1956 - APPLICATION FOR DEFERRED ANNUITY SEPARATION ON OR AFTER SEPTEMBER 30, 1956

ICR 198903-3206-010 · OMB 3206-0121 · Historical Active

Forms and Documents
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IC Document Collections
IC IDCollectionTypeStatusForm
176748 APPLICATION FOR DEFERRED ANNUITY - SEPARATION BEFORE SEPTEMBER 30, 1956 - APPLICATION FOR DEFERRED ANNUITY SEPARATION ON OR AFTER SEPTEMBER 30, 1956 Form Migrated
ICR Details
3206-0121 198903-3206-010
Historical Active 198608-3206-006
OPM
APPLICATION FOR DEFERRED ANNUITY - SEPARATION BEFORE SEPTEMBER 30, 1956 - APPLICATION FOR DEFERRED ANNUITY SEPARATION ON OR AFTER SEPTEMBER 30, 1956
No material or nonsubstantive change to a currently approved collection   No
Emergency 03/07/1989
Approved with change 03/07/1989
Retrieve Notice of Action (NOA) 03/07/1989
  Inventory as of this Action Requested Previously Approved
10/31/1989 10/31/1989 10/31/1989
3,000 0 4,400
1,500 0 2,200
0 0 0
THESE FORMS ARE COMPLETED BY FORMER FEDERAL EMPLOYEES AFTER REACHING AGE 62 WHEN APPLYING FOR DEFERRED ANNUITIES UNDER THE CIVIL SERVICE RETIREMENT SYSTEM. TWO FORMS ARE USED BECAUSE CERTAIN EMPLOYEES ARE N ELIGIBLE TO ELECT SURVIVOR ANNUITIES UNDER THE LAW.
None
None
No
  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 3,000 4,400 0 -1,400 0 0
Annual Time Burden (Hours) 1,500 2,200 0 -700 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
$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.
03/07/1989