OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

RI 34-1, 34-17, Financial Resources Questionnaire, RI 34-3, RI 34-19, Notice of Amount Due Because of Annuity Overpayment

ICR 201202-3206-003 · OMB 3206-0167 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form RI 34-1 Financial Resources Questionnaires, Notices of Amount Due Because of Annuity Overpayment Form and Instruction Modified Available
30-day FRN.pdf Supplementary Document Uploaded 2012-02-09 Available
60-day FRN.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-019 December 2008 Markup.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-019 Dec 2012 markup.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-017 Dec 2012 Markup.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-017 (12-08) Markup.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-003_March2008 Markup.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-003 December 2012 Markup.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-001_March2008 Markup.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-001 Dec 2012 Markup.pdf Supplementary Document Uploaded 2012-02-09 Available
RI 34-1 SS.doc Supporting Statement A Uploaded 2012-02-09 Available
IC Document Collections
IC IDCollectionTypeStatusForm
33642 Financial Resources Questionnaires, Notices of Amount Due Because of Annuity Overpayment Form and Instruction Modified
ICR Details
3206-0167 201202-3206-003
Historical Active 200910-3206-001
OPM
RI 34-1, 34-17, Financial Resources Questionnaire, RI 34-3, RI 34-19, Notice of Amount Due Because of Annuity Overpayment
Revision of a currently approved collection   No
Regular
Approved without change 04/14/2012
Retrieve Notice of Action (NOA) 02/13/2012
  Inventory as of this Action Requested Previously Approved
04/30/2015 36 Months From Approved 07/31/2012
2,081 0 2,081
2,081 0 2,081
0 0 0
Financial Resources Questionnaire (RI 34-1), Financial Resources Questionnaire - Federal Employees' Group Life Insurance Premiums Underpaid (RI 34-17), collects detailed financial information for use by OPM to determine whether to agree to a waiver, compromise, or adjustment of the collection of erroneous payments from the Civil Service Retirement and Disability Fund. Notice of Amount Due Because Of Annuity Overpayment (RI 34-3) and Notice of Amount Due Because of FEGLI Premium Underpayment (RI 34-19), informs the annuitant about the overpayment and collects information from the annuitant about how repayment will be made. Minor changes were made to the forms: updated organization name, added email address.
US Code: 31 USC Section 3716 Name of Law: Administrative Offset
  
None
Not associated with rulemaking
  76 FR 50770 08/16/2011
77 FR 5581 02/03/2012
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 2,081 2,081 0 0 0 0
Annual Time Burden (Hours) 2,081 2,081 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$126,000
No
Yes
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.
02/13/2012