OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

RI 25-41, Initial Certification of Full-time School Attendance

ICR 201606-3206-002 · OMB 3206-0099 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form RI 25-41 RI 25-41, Initial Certification of Full-time School Attendance Form and Instruction Modified Available
RI25-041_60DayFRNPublished_2016_03_08.pdf Supplementary Document Uploaded 2016-06-28 Repair queued
RI25-041_30day_publishedFRN.pdf Supplementary Document Uploaded 2016-06-28 Available
RI25-041_OMBSupportingStmt_2016_05_10.doc Supporting Statement A Uploaded 2016-06-28 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
33579 RI 25-41, Initial Certification of Full-time School Attendance Form and Instruction Modified
ICR Details
3206-0099 201606-3206-002
Historical Active 201212-3206-001
OPM
RI 25-41, Initial Certification of Full-time School Attendance
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 12/12/2016
Retrieve Notice of Action (NOA) 06/28/2016
This collection is approved for a year only. When resubmitted to OMB, OPM should include the applicable SORN and PIA as well as determine if the Privacy Act statement needs to be revised to more fully describe the routine uses of the collection.
  Inventory as of this Action Requested Previously Approved
12/31/2017 36 Months From Approved
1,200 0 0
1,800 0 0
0 0 0
RI 25-41 is used to determine whether a child is unmarried and a full-time student in a recognized school. OPM must determine this in order to pay survivor annuity benefits to children who are age 18 or older.
US Code: 5 USC Chapter 83, Section 8341(a)4 Name of Law: Civil Service Retirement
   US Code: 5 USC Chapter 84, Section 8441(4)(C) Name of Law: Federal Employees Retirement
  
None
Not associated with rulemaking
  81 FR 45 03/08/2016
81 FR 120 06/22/2016
No
1
IC Title Form No. Form Name
RI 25-41, Initial Certification of Full-time School Attendance RI 25-41 Initial Certification of Full-Time School Attendance
  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 1,200 0 0 0 0 1,200
Annual Time Burden (Hours) 1,800 0 0 0 0 1,800
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$13,750
No
No
No
No
No
Uncollected
Charles Conyers 202 606-0125 [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.
06/28/2016