Information Collection

RI 25-41, Initial Certification of Full-time School Attendance

IC 33579 under ICR 200911-3206-004 · OMB 3206-0099.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0099 can be found here:

Documents and Forms

Document Name Document Type
Form RI 25-41 RI 25-41, Initial Certification of Full-time School Attendance Form and Instruction
RI 25-41 Initial Certification of Full-Time School Attendance RI 25-41 10-09.pdf www.opm.gov/forms/pdf_fill/RI25-41.pdf Form and Instruction
RI 25-41 10-09 Markup.pdf RI 25-41 10-09 Markup.pdf IC Document
RI25-041_June2006 Mark up.pdf RI25-041_June2006 Mark up.pdf IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RI 25-41, Initial Certification of Full-time School Attendance	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 Ch I 831.672 5 CFR Ch I 843.410 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 25-41	Initial Certification of Full-Time School Attendance	RI 25-41 10-09.pdf	http://www.opm.gov/forms/pdf_fill/RI25-41.pdf	No		Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM/Central-1	FR Citation: 73 FR 15013

Number of Respondents: 1,200	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	1,200	1,200
Annual IC Time Burden (Hours)	1,800	1,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
RI 25-41 10-09 Markup.pdf	RI 25-41 10-09 Markup.pdf	11/04/2009
RI25-041_June2006 Mark up.pdf	RI25-041_June2006 Mark up.pdf	11/04/2009

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