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Federal forms, ICRs, and supporting documents

Information Collection

Do You Want To Provide A Survivor Annuity For Your Spouse?

IC 176768 under ICR 198507-3206-007 · OMB 3206-0139.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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Information Collection (IC) Details

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IC Title:

DO YOU WANT TO PROVIDE A SURVIVOR ANNUITY FOR YOUR SPOUSE?

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BRI 46-305A				No	No
Form	BRI 46-305				No	No

Federal Enterprise Architecture Business Reference Module

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	3,600	0	0	0	0	3,600
Annual IC Time Burden (Hours)	300	0	0	0	0	300
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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

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