OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

SF 2823, Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)

ICR 202203-3206-008 · OMB 3206-0136 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form SF 2823 Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI) Form and Instruction Unchanged Repair queued
OMB_Justification_SF2823_2022_03_07.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-03-08 Repair queued
SF2823_2014_05_MarkUp.pdf Supplementary Document Uploaded 2020-10-22 Repair queued
E8-5659.pdf Supplementary Document Uploaded 2020-10-22 Repair queued
SF2823_60DayFRNPublished_2020_03_09.pdf Supplementary Document Uploaded 2020-10-22 Repair queued
SF2823_30DayFRNPublished_2020_10_07.pdf Supplementary Document Uploaded 2020-10-22 Repair queued
SF 2823 Supporting Statement.docx Supporting Statement A Uploaded 2020-10-22 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
33600 Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI) Form and Instruction Unchanged
ICR Details
3206-0136 202203-3206-008
Received in OIRA 202010-3206-015
OPM SF 2823
SF 2823, Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)
No material or nonsubstantive change to a currently approved collection   No
Regular 03/08/2022
  Requested Previously Approved
12/31/2023 12/31/2023
48,000 48,000
12,000 12,000
0 0
Standard Form 2823 is used by any Federal employee or retiree covered by the Federal Employees' Group Life Insurance (FEGLI) Program, or an assignee who owns an insured's coverage, to instruct the Office of Federal Employees' Group Life Insurance how to distribute the proceeds of the FEGLI coverage when the statutory order of precedence does not meet his or her needs. The Privacy Act Statement has been revised due to a systematic review by our Chief Privacy Officer.
US Code: 5 USC Section 8705, Subpart G Name of Law: Insurance and Annuities
  
None
Not associated with rulemaking
  85 FR 13678 03/09/2020
85 FR 63301 10/07/2020
Yes
  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 48,000 48,000 0 0 0 0
Annual Time Burden (Hours) 12,000 12,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$12,700
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.
03/08/2022