OMB control number

Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84

OMB 3206-0268 · OPM.

OMB 3206-0268

RI 20-126 is used to certify that an employee performed certain service with the District of Columbia (DC) that qualifies under section 1905 of PL 111-84 for determining retirement eligibility. However, this service cannot be used in the computation of a retirement benefit.

The latest form for Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 expires 2029-02-28 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form RI120-126 Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 Form and Instruction
RI20-126_OMBSupportingStmt_2025.docx Supporting Statement A
E8-5659.pdf Supplementary Document
E8-5659.pdf Supplementary Document
Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 Form and Instruction
Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 Form and Instruction

All Historical Document Collections

202511-3206-005	Revision of a currently approved collection	2025-11-28
202211-3206-002 Approved with change	Reinstatement without change of a previously approved collection	2023-02-03
201905-3206-003 Approved with change	Reinstatement with change of a previously approved collection	2019-06-10
201510-3206-005 Approved with change	New collection (Request for a new OMB Control Number)	2015-10-29