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Federal forms, ICRs, and supporting documents

Information Collection Request

CSRS/FERS Documentation in Support of Disability Retirement Application

ICR 200008-3206-005 · OMB 3206-0228 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
33731 CSRS/FERS Documentation in Support of Disability Retirement Application Form Migrated
ICR Details
3206-0228 200008-3206-005
Historical Active 199612-3206-004
OPM
CSRS/FERS Documentation in Support of Disability Retirement Application
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 12/18/2000
Retrieve Notice of Action (NOA) 08/18/2000
OPM should review the Privacy Act statement used with this form to ensure that it is correct and consistent with the Privacy Statement used on other OPM forms.
  Inventory as of this Action Requested Previously Approved
12/31/2003 12/31/2003
12,775 0 0
12,775 0 0
0 0 0
SF-3112 collects information from applicants for disability retirement so that OPM can determine whether to approve a disability retirement.
None
None
No
1
IC Title Form No. Form Name
CSRS/FERS Documentation in Support of Disability Retirement Application SF-3112
  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 12,775 0 0 12,775 0 0
Annual Time Burden (Hours) 12,775 0 0 12,775 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
08/18/2000