Information Collection

RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit

IC 194854 under ICR 201010-3206-005 · OMB 3206-0254.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0254 can be found here:

Documents and Forms

Document Name Document Type
Form RI 20-123 RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit Form
RI 20-123 Request for Case Review for Enhanced Disability Annuity RI20-123_April2010_Updated.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	RI 20-123	Request for Case Review for Enhanced Disability Annuity Benefit	RI20-123_April2010_Updated.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: 720	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	720	720
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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