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Federal forms, ICRs, and supporting documents

Information Collection Request

DOCUMENTATION IN SUPPORT OF DISABILITY RETIREMENT APPLICATION

ICR 199206-3206-006 · 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
157027 DOCUMENTATION IN SUPPORT OF DISABILITY RETIREMENT APPLICATION Form Migrated
ICR Details
3206-0171 199206-3206-006
Historical Active 198905-3206-001
OPM
DOCUMENTATION IN SUPPORT OF DISABILITY RETIREMENT APPLICATION
Revision of a currently approved collection   No
Regular
Approved without change 09/08/1992
Retrieve Notice of Action (NOA) 06/11/1992
This request, as amended by the changes provided by OPM on 8/27/92, is given approval through 10/93. In light of the complexity of this form, OPM should study over the next year ways to make the format of the background material and instructions more seperately distinguishable to the user of this form. OPM's next request for OMB approval--to be submitted no later than 90 days before the 10/93 expiration date must reflect thorough consideration of alternative formats. As an alternative to printing this revised Standard Form to be used on a temporary basis through 10/93, OPM may continue to use the curren version of this form until an alternative version reflecting a changed format is developed and receives OMB approval. Approval to continue using the current version of the form also expires 10/93. Should OPM use the new version the following specific changes must be made on the newly-printed form: (1) The reference on p. 3 to "steps 1a or 1b" must be changed or two items appearing above it must be labeled as 1a and 1b. (2) The statement appearing opposite item 2 on p. 6 stating "FERS records are filed by name and date of birth" must be deleted, consistent with the other deletions of explanations. **Because OPM has apparently used this and other forms after expiratio dates since it has failed to submit requests for OMB approval less than 90 days from expiration of approval, OMB will consider discontinuing this policy for all OPM forms.***
  Inventory as of this Action Requested Previously Approved
10/31/1993 10/31/1993 08/31/1992
2,100 0 1,450
3,150 0 1,450
0 0 0
STANDARD FORM 3105 A-E ARE THE INSTRUMENTS BY WHICH AN EMPLOYEE PARTICIPATING IN THE FEDERAL EMPLOYEES RETIREMENT SYSTEM (FERS) APPLIE FOR RETIREMENT ON THE BASIS OF DISABILITY. THESE FORMS ARE THE MEANS BY WHICH OPM CAN OBTAIN THE DOCUMENTATION NECESSARY TO DETERMINE IF TH APPLICANT MEETS THE QUALIFICATIONS FOR DISABILITY RETIREMENT.
None
None
No
1
IC Title Form No. Form Name
DOCUMENTATION IN SUPPORT OF DISABILITY RETIREMENT APPLICATION SF 3105
  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 2,100 1,450 0 0 650 0
Annual Time Burden (Hours) 3,150 1,450 0 0 1,700 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.
06/11/1992