APPLICATION OF DISABILITY RETIREMENT UNDER FERS, SF 3106 A-E

ICR 198704-3206-001

OMB: 3206-0171

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
3206-0171 198704-3206-001
Historical Active
OPM
APPLICATION OF DISABILITY RETIREMENT UNDER FERS, SF 3106 A-E
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 04/08/1987
Retrieve Notice of Action (NOA) 04/06/1987
  Inventory as of this Action Requested Previously Approved
07/31/1987 07/31/1987
1,000 0 0
1,000 0 0
0 0 0

THESE DOCUMENTS STIPULATE THE DOCUMENTATION AND ELIGIBILITY REQUIREMEN FOR DISABILITY RETIREMENT UNDER FERS. ALLOWANCE OR DISALLOWANCE OF DISABILITY RETIREMENT IS BASED UPON INFORMATION PROVIDED IN AND WITH THESE FORMS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION OF DISABILITY RETIREMENT UNDER FERS, SF 3106 A-E SF 3105 A,, B, C, D, E

  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 1,000 0 0 1,000 0 0
Annual Time Burden (Hours) 1,000 0 0 1,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
04/06/1987


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