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Federal forms, ICRs, and supporting documents

Information Collection Request

OPM 1496A, Application for Deferred Retirement (Separations on or after October 1, 1956)

ICR 201112-3206-002 · OMB 3206-0121 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form OPM 1496A Application for Deferred Retirement (Separations on or after October 1, 1956) Form and Instruction Modified Available
OPM 1496A March 2012 Markup.pdf Supplementary Document Uploaded 2011-12-12 Available
OPM 1496A December 2010 markup.pdf Supplementary Document Uploaded 2011-12-12 Available
30-day FRN.pdf Supplementary Document Uploaded 2011-12-12 Repair queued
60-day FRN.pdf Supplementary Document Uploaded 2011-12-12 Available
OPM 1496A SS.doc Supporting Statement A Uploaded 2011-12-12 Available
IC Document Collections
IC IDCollectionTypeStatusForm
33585 Application for Deferred Retirement (Separations on or after October 1, 1956) Form and Instruction Modified
ICR Details
3206-0121 201112-3206-002
Historical Active 201012-3206-004
OPM
OPM 1496A, Application for Deferred Retirement (Separations on or after October 1, 1956)
Revision of a currently approved collection   No
Regular
Approved without change 01/25/2012
Retrieve Notice of Action (NOA) 12/12/2011
  Inventory as of this Action Requested Previously Approved
01/31/2015 36 Months From Approved 04/30/2014
2,800 0 2,800
2,800 0 2,800
0 0 0
OPM 1496A is used by eligible former Federal employees to apply for Civil Service annuity. The OPM 1496 is being removed because there are less than 10 respondents per year. The instructions attached to OPM Form 1496A have been revised to bring them up-to-date. The application now provides space for the applicant to enroll in Direct Deposit/Direct Express and to indicate how much Federal income tax should be withheld. Schedule B, Part 1 has been revised to collect the name of the former spouse should the applicant have elected a survivor benefit for that individual. Schedule C is no longer needed.
US Code: 5 USC 83 Name of Law: Civil Service Retirement
   US Code: 5 USC 8338 Name of Law: Deferred Retirement
  
None
Not associated with rulemaking
  76 FR 54811 09/02/2011
76 FR 76773 12/08/2011
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 2,800 2,800 0 0 0 0
Annual Time Burden (Hours) 2,800 2,800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$323,000
No
No
No
No
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.
12/12/2011