OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

RI 38-117, Rollover Election, RI 37-118, Rollover Information, and RI 37-22, Special Tax Notice Regarding Rollovers

ICR 202509-3206-001 · OMB 3206-0212 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form RI 38-17 Rollover Election Form Form and Instruction Modified Available
Form RI 38-17 RI 38-117, Rollover Election Form and Instruction Modified Repair queued
OMB RI 38-117 2025 Supporting Statement 03-26.docx Supporting Statement A Uploaded 2026-03-18 Available
OMB RI 38-117 2025 Supporting Statement.docx Supporting Statement A Uploaded 2025-09-26 Repair queued
E8-5659.pdf Supplementary Document Uploaded 2022-07-27 Available
E8-5659.pdf Supplementary Document Uploaded 2022-07-27 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
33708 RI 38-117, Rollover Election Form and Instruction ModifiedRollover Election Form
33708 RI 38-117, Rollover Election Form and Instruction Modified
33708 RI 38-117, Rollover Election Instruction Modified
ICR Details
3206-0212 202509-3206-001
Active 202207-3206-004
OPM RI 38-117, RI 37-118 and RI 37-22
RI 38-117, Rollover Election, RI 37-118, Rollover Information, and RI 37-22, Special Tax Notice Regarding Rollovers
Revision of a currently approved collection   No
Regular
Approved with change 04/08/2026
Retrieve Notice of Action (NOA) 09/26/2025
This collection is approved based on the revised materials provided by the Agency.
  Inventory as of this Action Requested Previously Approved
04/30/2029 36 Months From Approved 04/30/2026
1,500 0 1,500
1,000 0 1,000
32,660 0 60,249
RI 38-117, Rollover Election, is used to collect information from each payee affected by a change in the tax code so that OPM can make payment in accordance with the wishes of the payee. RI 38-118, Rollover Information, explains the election. RI 37-22, Special Tax Notice Regarding Rollovers, provides more detailed information.
PL: Pub.L. 107 - 16 641 Name of Law: Rollovers allowed among various types of plans
   PL: Pub.L. 107 - 16 643 Name of Law: Rollovers of after-tax contributions
   US Code: 26 USC 402(f) and 402(c)(2) Name of Law: Taxability of beneficiary of employees' trust
   US Code: 5 USC 8432(j)(2) Name of Law: Lump-sum benefits; designation of beneficiary; order of precedence
   PL: Pub.L. 107 - 147 411 Name of Law: Amendments related to Economic Growth and Tax Relief Reconciliation Act of 2001
  
None
Not associated with rulemaking
  90 FR 14665 04/03/2025
90 FR 46422 09/26/2025
No
1
IC Title Form No. Form Name
RI 38-117, Rollover Election RI 38-17 Rollover Election Form
  Total Approved 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 1,500 1,500 0 0 0 0
Annual Time Burden (Hours) 1,000 1,000 0 0 0 0
Annual Cost Burden (Dollars) 32,660 60,249 0 -27,589 0 0
No
No
$8,500
No
    Yes
    Yes
No
No
No
No
Alexys Stanley 202 606-1183 [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.
09/26/2025