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Federal forms, ICRs, and supporting documents

Information Collection Request

DOCUMENTATION IN SUPPORT OF DISABILITY RETIREMENT APPLICATION (FERS)

ICR 199404-3206-002 · 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
176799 DOCUMENTATION IN SUPPORT OF DISABILITY RETIREMENT APPLICATION (FERS) Form Migrated
ICR Details
3206-0171 199404-3206-002
Historical Active 199308-3206-006
OPM
DOCUMENTATION IN SUPPORT OF DISABILITY RETIREMENT APPLICATION (FERS)
No material or nonsubstantive change to a currently approved collection   No
Emergency 04/14/1994
Approved with change 04/14/1994
Retrieve Notice of Action (NOA) 04/14/1994
  Inventory as of this Action Requested Previously Approved
07/31/1994 07/31/1994 04/30/1994
3,100 0 3,100
4,650 0 4,650
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 (FERS) 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 3,100 3,100 0 0 0 0
Annual Time Burden (Hours) 4,650 4,650 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.
04/14/1994