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Federal forms, ICRs, and supporting documents

Information Collection Request

Former Spouse's Application for Survivor Annuity under the Civil Service Retirement System

ICR 199802-3206-002 · OMB 3206-0158 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
33628 Former Spouse's Application for Survivor Annuity under the Civil Service Retirement System Form Migrated
ICR Details
3206-0158 199802-3206-002
Historical Active 199410-3206-001
OPM
Former Spouse's Application for Survivor Annuity under the Civil Service Retirement System
Extension without change of a currently approved collection   No
Regular
Approved without change 04/06/1998
Retrieve Notice of Action (NOA) 02/11/1998
  Inventory as of this Action Requested Previously Approved
04/30/2001 04/30/2001 04/30/1998
500 0 500
375 0 375
0 0 0
OPM form 1536 is designed for use by former spouses of Federal employees and annuitants who are applying for a monthly benefit. This application collects information about whether the applicant is covered by the Federal Employees Health Benefits Program and about any court order which awards the applicant retirement benefits.
None
None
No
1
IC Title Form No. Form Name
Former Spouse's Application for Survivor Annuity under the Civil Service Retirement System 1536
  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 500 500 0 0 0 0
Annual Time Burden (Hours) 375 375 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.
02/11/1998