Information Collection

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

IC 33642 under ICR 200711-3206-006 · 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⚠️ Notice: This information collection may be referencing outdated material.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 34-1 Financial Resources Questionnaire, Notice of Amount Due Because of Annuity Overpayment Form and Instruction
RI 34-1 Financial Resources Questionnaire RI 34-1 revised Aug 2007.pdf Form and Instruction
RI 34-1 2005 and 2007 markups.pdf RI 34-1, Financial Resources Questionnaire. 2005 and 2007 Markups 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? No		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 and Instruction	RI 34-1	Financial Resources Questionnaire	RI 34-1 revised Aug 2007.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

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 34-1, Financial Resources Questionnaire. 2005 and 2007 Markups	RI 34-1 2005 and 2007 markups.pdf	11/08/2007

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