OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Combined Federal Campaign (CFC) Form 1654-B (Retiree Pledge Form)

ICR 202009-3206-004 · OMB 3206-0271 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Statement A 1654 B Retiree 3206 0271 (Revised 29 SEP 2020).docx Supporting Statement A Uploaded 2020-09-29 Missing upstream
30 Day Notice 42444 ICR 3206 0271.pdf Supplementary Document Uploaded 2020-09-22 Repair queued
60 Day Notice 20726 3206 0271.pdf Supplementary Document Uploaded 2020-09-22 Repair queued
CFC SORN 2019 .docx Supplementary Document Uploaded 2020-09-22 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
228913 Annuitant Pledge Form Modified
ICR Details
3206-0271 202009-3206-004
Received in OIRA 201711-3206-001
OPM OPM 1654B
Combined Federal Campaign (CFC) Form 1654-B (Retiree Pledge Form)
Revision of a currently approved collection   No
Regular 09/29/2020
  Requested Previously Approved
36 Months From Approved 01/31/2021
250,000 250,000
125,000 125,000
408,175 0
Abstract: The Combined Federal Campaign (CFC) is the world’s largest and most successful annual workplace philanthropic giving campaign. The mission of the CFC is to promote and support philanthropy through a program that is employee-focused, cost-efficient, and effective in providing all federal employees the opportunity to improve the quality of life for all. With the signing of Executive Order 13743 on October 13, 2016, authorizing the solicitation of federal annuitants, the Combined Federal Campaign Annuitant Pledge Form will be used to collect and process federal annuitant and military retirees’ pledges through the Combined Federal Campaign.
EO: EO 13743 Name/Subject of EO: Charitable Fundraising
  
None
Not associated with rulemaking
  85 FR 20726 04/14/2020
85 FR 42444 07/14/2020
No
1
IC Title Form No. Form Name
Annuitant Pledge Form
  Total Request 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 250,000 250,000 0 0 0 0
Annual Time Burden (Hours) 125,000 125,000 0 0 0 0
Annual Cost Burden (Dollars) 408,175 0 0 408,175 0 0
No
No
$0
No
    Yes
    Yes
No
No
No
No
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.
09/29/2020