OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)

ICR 200711-3206-002 · OMB 3206-0136 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form SF-2823 Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI) Form Modified Available
SF 2823_Support_Stmt_August2007 No B.pdf Supporting Statement A Uploaded 2007-11-07 Available
IC Document Collections
IC IDCollectionTypeStatusForm
33600 Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI) Form Modified
ICR Details
3206-0136 200711-3206-002
Historical Active 200402-3206-006
OPM
Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)
Extension without change of a currently approved collection   No
Regular
Approved without change 12/10/2007
Retrieve Notice of Action (NOA) 11/09/2007
  Inventory as of this Action Requested Previously Approved
12/31/2010 36 Months From Approved 12/31/2007
48,000 0 48,000
12,000 0 12,000
0 0 0
This form is used by any Federal employees, Annuitants, or Assignees covered by or owned through the FEGLI Program to designate beneficiaries to receive life insurance proceeds when the statutory order of precedence does not meet the individual's needs.
US Code: 5 USC Section 8705, Subpart G Name of Law: Insurance and Annuities
  
None
Not associated with rulemaking
  72 FR 26184 05/08/2007
72 FR 62883 11/07/2007
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 48,000 48,000 0 0 0 0
Annual Time Burden (Hours) 12,000 12,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$12,700
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Mary Smith-Toomey 202 606-8358 [email protected]
  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.
11/09/2007