OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

RI 20-7 - Representative Payee Application, RI 30-3 - Information Necessary for a Competency Determination

ICR 201305-3206-004 · OMB 3206-0140 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form RI 20-7 RI 20-7, Representative Payee Application/RI 30-3, Information Necessary for a Competency Determination Form and Instruction Modified Available
RI30-3 June 2010 markup.pdf Supplementary Document Uploaded 2013-05-14 Available
RI 30-3 Aug 2013 markup.pdf Supplementary Document Uploaded 2013-05-14 Available
RI 20-7 June 2010 markup.pdf Supplementary Document Uploaded 2013-05-14 Available
RI 20-7 August 2013 markup.pdf Supplementary Document Uploaded 2013-05-14 Available
30-day FRN.pdf Supplementary Document Uploaded 2013-05-14 Available
60-day FRN.pdf Supplementary Document Uploaded 2013-05-14 Available
RI 20-7 SS.doc Supporting Statement A Uploaded 2013-05-14 Available
IC Document Collections
IC IDCollectionTypeStatusForm
33606 RI 20-7, Representative Payee Application/RI 30-3, Information Necessary for a Competency Determination Form and Instruction Modified
ICR Details
3206-0140 201305-3206-004
Historical Active 201004-3206-009
OPM
RI 20-7 - Representative Payee Application, RI 30-3 - Information Necessary for a Competency Determination
Revision of a currently approved collection   No
Regular
Approved without change 06/14/2013
Retrieve Notice of Action (NOA) 05/15/2013
  Inventory as of this Action Requested Previously Approved
06/30/2016 36 Months From Approved 07/31/2013
12,480 0 12,480
6,490 0 6,490
0 0 0
RI 20-7, Representative Payee Application, is used by the Civil Service Retirement System (CSRS) and the Federal Employees Retirement System (FERS) to collect information from persons applying to be fiduciaries for annuitants or survivor annuitants who appear to be incapable of handling their own funds or for minor children. RI 30-3, Information Necessary for a Competency Determination, collects medical information regarding the annuitant's competency for OPM's use in evaluating the annuitant's condition. Both forms have been revised to bring the Public Burden Statement up-to-date.
US Code: 5 USC Chapter 83 Section 8345 Name of Law: CSRS, Payment of Benefits; commencement, termination, and waiver of annuity
   US Code: 5 USC Chapter 83 Section 8344 Name of Law: CSRS, Annuities & Pay on Reemployment
   US Code: 5 USC Chapter 84 Section 8466 Name of Law: FERS, Application for Benefits
  
None
Not associated with rulemaking
  77 FR 71200 11/20/2012
78 FR 28007 05/13/2013
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 12,480 12,480 0 0 0 0
Annual Time Burden (Hours) 6,490 6,490 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$198,850
No
No
No
No
No
Uncollected
Steve Pierce 202 606-2560 [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.
05/15/2013