OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When Deceased Was an...

ICR 200904-3206-006 · OMB 3206-0156 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form SF-2800 Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When Deceased Was an... Form and Instruction Modified Available
60-day FRN.pdf Supplementary Document Uploaded 2009-04-21 Available
FRN.pdf Supplementary Document Uploaded 2009-04-21 Available
SF2800-1 (12-08).pdf Supplementary Document Uploaded 2009-04-21 Available
SF2800A_June2006MarkUp.pdf Supplementary Document Uploaded 2009-04-20 Available
SF2800A_December2008MarkUp.pdf Supplementary Document Uploaded 2009-04-20 Available
SF2800_June2006MarkUp.pdf Supplementary Document Uploaded 2009-04-20 Available
SF2800_December2008MarkUp.pdf Supplementary Document Uploaded 2009-04-20 Available
3206-0156_SS.doc Supporting Statement A Uploaded 2009-06-24 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
33627 Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When Deceased Was an... Form and Instruction Modified
ICR Details
3206-0156 200904-3206-006
Historical Active 200508-3206-002
OPM
Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When Deceased Was an...
Revision of a currently approved collection   No
Regular
Approved without change 06/25/2009
Retrieve Notice of Action (NOA) 04/30/2009
  Inventory as of this Action Requested Previously Approved
06/30/2012 36 Months From Approved 06/30/2009
74,800 0 56,100
56,100 0 56,100
0 0 0
SF 2800 is needed to collect information so that OPM can pay death benefits to the survivors of Federal employees and annuitants. SF 2800A is needed for deaths in service so that survivors can make the needed election regarding military service. Every applicant who uses SF 2800 should read SF 2800-1, Applying for Death Benefits under CSRS. This brief booklet provides the general information applicants need to understand what they are applying for.
US Code: 5 USC Chapter 83, Section 8341 Name of Law: Survivor Annuities
   US Code: 5 USC Chapter 83, Section 8342 Name of Law: Lump-sum benefits; designation of beneficiary; order
  
None
Not associated with rulemaking
  73 FR 74536 12/08/2008
74 FR 14171 03/30/2009
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 74,800 56,100 0 18,700 0 0
Annual Time Burden (Hours) 56,100 56,100 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$1,201,200
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.
04/30/2009