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Federal forms, ICRs, and supporting documents

Information Collection Request

Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....

ICR 200309-3206-004 · OMB 3206-0174 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
33658 Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the.... Form Migrated
ICR Details
3206-0174 200309-3206-004
Historical Active 200003-3206-006
OPM
Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 12/24/2003
Retrieve Notice of Action (NOA) 09/25/2003
  Inventory as of this Action Requested Previously Approved
12/31/2006 12/31/2006
2,400 0 0
1,834 0 0
0 0 0
RI 20-63 is used by annuitants to elect a reduced annuity with a survivor annuity for their spouse. RI 20-116 and 20-117 are cover letters that give the cost of the election. RI 20-117 may be used to ask for more information or to decline to elect. RI 20-116 may be used to decline to elect.
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 2,400 0 0 2,400 0 0
Annual Time Burden (Hours) 1,834 0 0 1,834 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.
09/25/2003