Information Collection

Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity

IC 33603 under ICR 202403-3206-003 · OMB 3206-0138.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0138 can be found here:

Documents and Forms

Document Name Document Type
Form RI 30-9 Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity Form and Instruction
Form RI 30-9 Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity Form and Instruction
RI 30-9 Reinstatement of Disability Annuity Previously Terminate RI30-009_2021_01_Markup.pdf www.opm.gov Form and Instruction
RI 30-9 Reinstatement of Disability Annuity Previously Terminate RI30-009_2021_01_Markup.pdf www.opm.gov Form and Instruction
RI 30-9 Reinstatement of Disability Annuity Previously Terminate RI30-009_2024_04.pdf www.opm.gov Form and Instruction
RI 30-9 Reinstatement of Disability Annuity Previously Terminate RI30-009_2024_04.pdf www.opm.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity	Agency IC Tracking Number:	RI 30-9

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 831.1211 5 CFR 844.404

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 30-9	Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity	RI30-009_2024_04.pdf	www.opm.gov	Yes	No	Printable Only

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: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	5,375	5,375

Documents for IC

Title	Document	Date Uploaded
No associated records found

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