Information Collection

Annuitant's Report of Earned Income

IC 33551 under ICR 202212-3206-003 · OMB 3206-0034.

Documents and Forms

Document Name Document Type
RI30-002_2023_01.pdf RI 30-002_2023_01Revised IC Document
RI30-002_2022_01MarkUp.pdf RI 30-002_2022_01MarkUp 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: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR Ch I 831.1209 5 CFR Ch I 844.402 (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: 59,081	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	59,081	38,081	21,000
Annual IC Time Burden (Hours)	16,650	4,400	12,250
Annual IC Cost Burden (Dollars)	500,277	171,364	328,913

Documents for IC

Title	Document	Date Uploaded
RI 30-002_2023_01Revised	RI30-002_2023_01.pdf	12/16/2022
RI 30-002_2022_01MarkUp	RI30-002_2022_01MarkUp.pdf	12/16/2022

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