Information Collection

12-month Follow-up Survey

IC 258378 under ICR 202603-0960-004 · OMB 0960-0829.

Documents and Forms

Document Name Document Type
Appendix B.6. VRFD Follow-up Survey (Revised).docx Other-Appendix B.6. Follow-up Survey
Appendix B.1. VRFD Advance -(Revised).docx Other-Appendix B.1.VRFD Advance Noti
Appendix B.2. VRFD Reminder Letter - (Revised).docx Other-Appendix B.2. VRFD Reminder Le
Appendix B.7. Informed Consent - (Revised).docx Other-Appendix B.7. Informed Consent
Revised PRA Statement.docx Other-Revised PRA Statement
Appendix B.1. VRFD Advance -(Current).docx Appendix B.1. VRFD Advance (Current) IC Document
Appendix B.2. VRFD Reminder Letter- (Current).docx Appendix B.2. VRFD Reminder Letter (Current) IC Document
Appendix B.7. Informed Consent -(Current).docx Appendix B.7. Informed Consent (Current) IC Document
Appendix B.3. VRFD Postcard Reminder Text.docx Appendix B.3. VRFD Postcard Reminder IC Document
Appendix B.6. VRFD Follow-up Survey.docx Appendix B.6. VRFD Follow-up Survey IC Document
Appendix B.4. VRFD Thank you Incentive Letter.docx B.4. Thank You Incentive Letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	12-month Follow-up Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix B.6. Follow-up Survey - Revised	Appendix B.6. VRFD Follow-up Survey (Revised).docx	Yes	Yes	Fillable Fileable
Other-Appendix B.1.VRFD Advance Notice (Revised)	Appendix B.1. VRFD Advance -(Revised).docx	Yes	Yes	Fillable Fileable
Other-Appendix B.2. VRFD Reminder Letter (Revied)	Appendix B.2. VRFD Reminder Letter - (Revised).docx	Yes	No	Fillable Printable
Other-Appendix B.7. Informed Consent (Revised)	Appendix B.7. Informed Consent - (Revised).docx	No		Paper Only
Other-Revised PRA Statement	Revised PRA Statement.docx	No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	90	-310	400
Annual IC Time Burden (Hours)	38	-489	527
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix B.1. VRFD Advance (Current)	Appendix B.1. VRFD Advance -(Current).docx	05/22/2026
Appendix B.2. VRFD Reminder Letter (Current)	Appendix B.2. VRFD Reminder Letter- (Current).docx	05/22/2026
Appendix B.7. Informed Consent (Current)	Appendix B.7. Informed Consent -(Current).docx	05/22/2026
Appendix B.3. VRFD Postcard Reminder	Appendix B.3. VRFD Postcard Reminder Text.docx	05/22/2026
Appendix B.6. VRFD Follow-up Survey	Appendix B.6. VRFD Follow-up Survey.docx	05/22/2026
B.4. Thank You Incentive Letter	Appendix B.4. VRFD Thank you Incentive Letter.docx	05/22/2026

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

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