OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

RI 20-126, Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84

ICR 201510-3206-005 · OMB 3206-0268 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
opm-sorn-central-1-civil-service-retirement-and-insurance-records.pdf Supplementary Document Uploaded 2016-03-04 Available
2015-24425 30-Day FRN.pdf Supplementary Document Uploaded 2015-10-05 Available
RI20-126_60DayFRN_Publication.pdf Supplementary Document Uploaded 2015-10-05 Available
RI 20-126 February 2015.pdf Supplementary Document Uploaded 2015-10-05 Available
RI20-126_OMBSupportingStatement_2015.doc Supporting Statement A Uploaded 2015-10-05 Available
IC Document Collections
IC IDCollectionTypeStatusForm
218495 Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 New
ICR Details
3206-0268 201510-3206-005
Historical Active
OPM
RI 20-126, Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 03/25/2016
Retrieve Notice of Action (NOA) 10/29/2015
This collection is approved based on the additional materials provided by the Agency.
  Inventory as of this Action Requested Previously Approved
03/31/2019 36 Months From Approved
1,000 0 0
500 0 0
0 0 0
RI 20-126 is used to certify that an employee performed certain service with the District of Columbia (DC) that qualifies under section 1905 of PL 111-84 for determining retirement eligibility. However, this service cannot be used in the computation of a retirement benefit.
PL: Pub.L. 111 - 84 1905 Name of Law: Certification of Qualifying DC Service Under Public Law 111-84 Sec 1905
  
None
Not associated with rulemaking
  80 FR 25337 05/04/2015
80 FR 57887 09/25/2015
No
1
IC Title Form No. Form Name
Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84
  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 1,000 0 0 1,000 0 0
Annual Time Burden (Hours) 500 0 0 500 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New Collection
$5,550
No
No
No
No
No
Uncollected
Alicia Hoefke 202 606-2514 [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.
10/29/2015