ANNUITANTS AND DEPENDENT CHILDREN

ICR 198107-3206-008

OMB: 3206-0059

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
176651 Migrated
ICR Details
3206-0059 198107-3206-008
Historical Active 198010-3206-002
OPM
ANNUITANTS AND DEPENDENT CHILDREN
No material or nonsubstantive change to a currently approved collection   No
Emergency 07/17/1981
Approved with change 07/17/1981
Retrieve Notice of Action (NOA) 07/17/1981
  Inventory as of this Action Requested Previously Approved
07/31/1984 07/31/1984 10/31/1985
500 0 500
125 0 125
0 0 0

THE FORM ALLOWS SURVIVORS ANNUITANTS AND/OR DEPENDENT CHILDREN RECEIVING ANNUNITIES TO APPLY FOR THE MINIMUM ANNUITY UNDER P.L. 93-273. IT REQUESTS THE INFORMATION NECESSARY FOR DETERMINING ELIGIBILITY AND FOR THE VERIFICATION OF THAT INFORMATION WITH OTHER FEDERAL AGENCIES FROM WHICH THEY MAY BE RECEIVING (OR ARE ENTITLED TO RECEIVE) ANNUNITY OR RETIREMENT PAY.

None
None


No

1
IC Title Form No. Form Name
ANNUITANTS AND DEPENDENT CHILDREN BRI 49-389A

  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 500 500 0 0 0 0
Annual Time Burden (Hours) 125 125 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
07/17/1981


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