OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....

ICR 201607-3206-006 · OMB 3206-0174 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form RI 20-63 Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the.... Form and Instruction Unchanged Available
RI20-117_2016_08_ROC_Mark Up.pdf Supplementary Document Uploaded 2016-07-21 Available
RI20-117_2016_08_DC_MarkUp.pdf Supplementary Document Uploaded 2016-07-21 Available
RI20-117_2016_08_ROC.pdf Supplementary Document Uploaded 2016-07-21 Available
RI20-117_2016_08_DC.pdf Supplementary Document Uploaded 2016-07-21 Repair queued
RI 20 -117 DC revised November 2013 Markup.pdf Supplementary Document Uploaded 2016-07-21 Repair queued
RI20-116_2016_08_ROC_MarkUp.pdf Supplementary Document Uploaded 2016-07-21 Repair queued
RI20-116_2016_08_DC_MarkUp.pdf Supplementary Document Uploaded 2016-07-21 Available
RI20-116_2016_08_ROC.pdf Supplementary Document Uploaded 2016-07-21 Available
RI20-116_2016_08_DC.pdf Supplementary Document Uploaded 2016-07-21 Available
RI 20-116 ROC Sept 2013.pdf Supplementary Document Uploaded 2016-07-21 Available
RI20-116_2013_11_DC.pdf Supplementary Document Uploaded 2016-07-21 Available
RI 20-63 _2016_8.pdf Supplementary Document Uploaded 2016-07-21 Repair queued
RI20-063_2011_08_MarkUp.pdf Supplementary Document Uploaded 2016-07-21 Repair queued
RI20-063_2016_08_MarkUp.pdf Supplementary Document Uploaded 2016-07-21 Available
RI20-063_30DayFRN_2016_05_09.doc Supplementary Document Uploaded 2016-07-21 Available
RI20-063_60DayFRN_2015.docx Supplementary Document Uploaded 2016-07-21 Available
RI20-063_OMB_SuppStmt_2016_06_09.doc Supporting Statement A Uploaded 2016-07-21 Available
IC Document Collections
IC IDCollectionTypeStatusForm
33658 Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the.... Form and Instruction Unchanged
ICR Details
3206-0174 201607-3206-006
Historical Active 201307-3206-007
OPM
Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....
Revision of a currently approved collection   No
Regular
Approved without change 12/12/2016
Retrieve Notice of Action (NOA) 08/16/2016
This collection is approved for a year only. When resubmitting this collection, OPM needs to provide the applicable SORN and PIA as well as determine if the Privacy Act statement needs to be revised to better describe the routine uses of this information.
  Inventory as of this Action Requested Previously Approved
12/31/2017 36 Months From Approved 12/31/2016
2,400 0 2,400
1,834 0 1,834
0 0 0
RI 20-63 is used by annuitants to elect a reduced annuity with a survivor annuity for their spouse. RI 20-116 and 20-117 are cover letters that give the cost of the election. RI 20-117 may be used to ask for more information or to decline to elect. RI 20-116 may be used to decline to elect.
US Code: 5 USC 8339(j)(5)(C)(i) and (k)(2) Name of Law: Computation of Annuity
   US Code: 5 USC 8416(b) and (c) Name of Law: Survivor reduction for a current spouse
  
None
Not associated with rulemaking
  81 FR 34 02/22/2016
81 FR 132 07/11/2016
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 2,400 2,400 0 0 0 0
Annual Time Burden (Hours) 1,834 1,834 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$142,800
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.
08/16/2016