Information Collection

Annuitant's Report of Earned Income

IC 33551 under ICR 201703-3206-002 · OMB 3206-0034.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0034 can be found here:

Documents and Forms

Document Name Document Type
RI30-002_2016_01_Form.pdf RI30-002_2016_01_Form IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annuitant's Report of Earned Income	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR Ch I 844.402 5 CFR Ch I 831.1209 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM/Central-1	FR Citation: 73 FR 15013

Number of Respondents: 21,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	21,000	21,000
Annual IC Time Burden (Hours)	12,250	12,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
RI30-002_2016_01_Form	RI30-002_2016_01_Form.pdf	06/23/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.