OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Refund of Retirement Deductions (FERS)/Current-Former Spouse's Notification of Application for Refund of Retirement Deductions Under the....

ICR 202203-3206-010 · OMB 3206-0170 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form SF 3106/3106A Application for Refund of Retirement Deductions/Federal Employees Retirement System (SF 3106) Current/Former Spouse's Notification of Application for Refund of Retirement Deductions Under the.... Form and Instruction Unchanged Missing upstream
OMB_Justification_SF3106_2022_03_08.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-03-08 Missing upstream
SF3106_3106A_30DayFRNPublished_2021_06_28.pdf Supplementary Document Uploaded 2021-06-29 Repair queued
2020-28900.pdf Supplementary Document Uploaded 2021-06-29 Repair queued
FACES 2017 FINAL 12212017signed.pdf Supplementary Document Uploaded 2017-12-29 Repair queued
ARS PIA Final 12212017signed.pdf Supplementary Document Uploaded 2017-12-29 Repair queued
SF 3106 citations.pdf Supplementary Document Uploaded 2017-12-29 Repair queued
SF3106_SF3106A_OMBSupportingStmt_2021_08_31.docx Supporting Statement A Uploaded 2021-08-31 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
33648 Application for Refund of Retirement Deductions/Federal Employees Retirement System (SF 3106) Current/Former Spouse's Notification of Application for Refund of Retirement Deductions Under the.... Form and Instruction Unchanged
ICR Details
3206-0170 202203-3206-010
Received in OIRA 202106-3206-010
OPM SF 3106/SF 3106A
Application for Refund of Retirement Deductions (FERS)/Current-Former Spouse's Notification of Application for Refund of Retirement Deductions Under the....
No material or nonsubstantive change to a currently approved collection   No
Regular 03/08/2022
  Requested Previously Approved
09/30/2024 09/30/2024
14,400 14,400
4,533 4,533
121,900 121,900
SF 3106 is used by former Federal employees under the Federal Employees Retirement System, to apply for a refund of retirement deductions withheld during Federal employment, plus any interest provided by law. SF 3106A is used by refund applicants to notify their current/former spouse(s) that they are applying for a refund of retirement deductions, which is required by law.
US Code: 5 USC Chapter 84 Name of Law: Federal Employees Retirement System
   PL: Pub.L. 111 - 84 Title XIX Name of Law: Federal Employee Benefits
  
None
Not associated with rulemaking
  85 FR 86583 12/30/2020
86 FR 34060 06/28/2021
No
  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 14,400 14,400 0 0 0 0
Annual Time Burden (Hours) 4,533 4,533 0 0 0 0
Annual Cost Burden (Dollars) 121,900 121,900 0 0 0 0
No
No
$136,512
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