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Federal forms, ICRs, and supporting documents

Information Collection Request

RI 30-1, Request to Disability Annuitant for Information on Physical Condition and Employment

ICR 201005-3206-001 · OMB 3206-0143 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form RI 30-1 Request to Disability Annuitant for Information on Physical Condition and Employment Form and Instruction Modified Available
OMB 30-1 SS.doc Supporting Statement A Uploaded 2010-05-03 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
33615 Request to Disability Annuitant for Information on Physical Condition and Employment Form and Instruction Modified
ICR Details
3206-0143 201005-3206-001
Historical Active 200707-3206-001
OPM
RI 30-1, Request to Disability Annuitant for Information on Physical Condition and Employment
Revision of a currently approved collection   No
Regular
Approved without change 07/02/2010
Retrieve Notice of Action (NOA) 05/04/2010
  Inventory as of this Action Requested Previously Approved
07/31/2013 36 Months From Approved 08/31/2010
8,000 0 8,000
8,000 0 8,000
0 0 0
Persons who are not yet age 60 and who are receiving disability annuity are subject to inquiry as to their medical condition as OPM deems reasonably necessary. RI 30-1 collects information as to whether the disabling condition has changed.
US Code: 5 USC 84 Section 8454 Name of Law: FERS, Medical Examination
   US Code: 5 USC 84 Section 8455 Name of Law: FERS, Recovery & Restoration of Earning Capacity
   US Code: 5 USC 84 Section 8464a Name of Law: FERS, Relationship between annuity and workers' compensation
   US Code: 5 USC 83 Section 8337 Name of Law: CSRS, Disability Retirement
  
None
Not associated with rulemaking
  74 FR 69154 12/30/2009
75 FR 22870 04/30/2010
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 8,000 8,000 0 0 0 0
Annual Time Burden (Hours) 8,000 8,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$93,900
No
No
No
Uncollected
No
Uncollected
Miles Windsor 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.
05/04/2010