Information Collection

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....

IC 33658 under ICR 200705-3206-002 · OMB 3206-0174.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0174 can be found here:

Documents and Forms

Document Name Document Type
Form RI-20-63 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
RI-20-63 Survivor Annuity Election for a Spouse RI 20-63 (12-06).pdf Form
RI-20-116 Cover letter for RI 20-63 Giving Information About the C RI20-116.pdf Form
RI-20-117 Cover Letter for RI 20-63 Giving Information About the C RI20-117.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	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....	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 831.631 5 CFR 831.632 5 CFR 842.611 5 CFR 842.612 5 CFR 842.613 5 CFR 842.614 5 CFR 842.615

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	RI-20-63	Survivor Annuity Election for a Spouse	RI 20-63 (12-06).pdf	No	Fillable Printable
Form	RI-20-116	Cover letter for RI 20-63 Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity	RI20-116.pdf	No	Fillable Printable
Form	RI-20-117	Cover Letter for RI 20-63 Giving Information About the Cost to Elect the Maximum Survivor Annuity	RI20-117.pdf	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM/Central-1	FR Citation: 65 FR 25775

Number of Respondents: 2,400	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	2,400	2,400
Annual IC Time Burden (Hours)	1,834	1,834
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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