OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

RI 34-1 and 34-17, Financial Resources Questionnaire, RI 34-3 and RI 34-19, Notice of Amount Due Because of Annuity Overpayment

ICR 200901-3206-001 · OMB 3206-0167 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form RI 34-1 Financial Resources Questionnaires, Notices of Amount Due Because of Annuity Overpayment Form and Instruction Modified Available
RI 34-1 revised SS.doc Supporting Statement A Uploaded 2009-06-25 Repair queued
60-Day FRN.pdf Supplementary Document Uploaded 2009-06-02 Available
RI 34-1 FRN.pdf Supplementary Document Uploaded 2009-06-02 Available
IC Document Collections
IC IDCollectionTypeStatusForm
33642 Financial Resources Questionnaires, Notices of Amount Due Because of Annuity Overpayment Form and Instruction Modified
ICR Details
3206-0167 200901-3206-001
Historical Active 200803-3206-001
OPM
RI 34-1 and 34-17, Financial Resources Questionnaire, RI 34-3 and RI 34-19, Notice of Amount Due Because of Annuity Overpayment
Revision of a currently approved collection   No
Regular
Approved without change 07/29/2009
Retrieve Notice of Action (NOA) 06/29/2009
  Inventory as of this Action Requested Previously Approved
07/31/2012 36 Months From Approved 07/31/2009
2,081 0 2,081
2,081 0 2,081
0 0 0
Financial Resources Questionnaire, forms RI 34-1 and RI 34-17, collects detailed financial information for use by OPM to determine whether to agree to a waiver, compromise, or adjustment of the collection of erroneous payments from the Civil Service Retirement and Disability Fund. Notice of Amount Due Because Of Annuity Overpayment, forms RI 34-3 and RI 34-19, informs the annuitant about the overpayment and collects information from the annuitant about how repayment will be made. RI 34-17 and RI 34-19 are new forms created at the request of the Office of the General Counsel and the Insurance Policy Group to clearly differentiate between annuity overpayments and insurance premium underpayments.
US Code: 31 USC Section 3716 Name of Law: Administrative Offset
  
None
Not associated with rulemaking
  73 FR 58685 10/07/2008
74 FR 23224 05/18/2009
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 2,081 2,081 0 0 0 0
Annual Time Burden (Hours) 2,081 2,081 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$114,200
No
Yes
Uncollected
Uncollected
No
Uncollected
Cyrus Benson 202 606-0623 [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.
06/29/2009