OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When the Deceased Was an Employee at the Time of..

ICR 200203-3206-001 · OMB 3206-0156 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
33626 Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When the Deceased Was an Employee at the Time of.. Form Migrated
ICR Details
3206-0156 200203-3206-001
Historical Active 199901-3206-001
OPM
Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When the Deceased Was an Employee at the Time of..
Extension without change of a currently approved collection   No
Regular
Approved without change 05/07/2002
Retrieve Notice of Action (NOA) 03/19/2002
  Inventory as of this Action Requested Previously Approved
05/31/2005 05/31/2005 05/31/2002
74,800 0 2
56,100 0 56,100
0 0 0
SF 2800 is needed to collect information so that OPM can pay death benefits to the survivors of Federal employees and anuitants. SF 2800A is needed for deaths in service only so that survivors can make the needed elections regarding military service.
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 74,800 2 0 74,798 0 0
Annual Time Burden (Hours) 56,100 56,100 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.
03/19/2002