Information Collection

Financial Resources Questionnaire, Notice of Amount Due Because of Annuity Overpayment

IC 33642 under ICR 200611-3206-002 · OMB 3206-0167.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0167 can be found here:

Documents and Forms

Document Name Document Type
Form RI-34-3 Financial Resources Questionnaire, Notice of Amount Due Because of Annuity Overpayment Form
RI-34-3 Notice of Amount Due Because of Annuity Overpayment RI34-3original06.pdf Form
RI34-3.pdf.04.pdf RI 34-3 with highlighted changes IC Document
RI34-3markup.pdf RI 34-3 (06) with highlighted revisions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Financial Resources Questionnaire, Notice of Amount Due Because of Annuity Overpayment	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	RI-34-3	Notice of Amount Due Because of Annuity Overpayment	RI34-3original06.pdf		No		Fillable Printable

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,081	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,081	2,081
Annual IC Time Burden (Hours)	2,081	2,081
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
RI 34-3 with highlighted changes	RI34-3.pdf.04.pdf	11/21/2006
RI 34-3 (06) with highlighted revisions	RI34-3markup.pdf	11/21/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.