APPLICATION FOR REFUND OF RETIREMENT DEDUCTIONS (CSRS)

ICR 199004-3206-001

OMB: 3206-0128

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
156893 Migrated
ICR Details
3206-0128 199004-3206-001
Historical Active 198612-3206-002
OPM
APPLICATION FOR REFUND OF RETIREMENT DEDUCTIONS (CSRS)
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 05/29/1990
Retrieve Notice of Action (NOA) 04/17/1990
  Inventory as of this Action Requested Previously Approved
03/31/1993 03/31/1993
60,000 0 0
60,000 0 0
0 0 0

A FORMER FEDERAL EMPLOYEE, SEPARATED NOT FOR DEATH OR RETIREMENT, MAY APPLY FOR A REFUND OF RETIREMENT DEDUCTIONS MADE TO THE CIVIL SERVICE AND RETIREMENT SYSTEM. STANDARD FORM 2802 AND STANDARD FORM 2802B ARE THE FORMS THE INDIVIDUAL USES TO FURNISH OPM WITH IDENTIFICATION, THE FEDERAL SERVICE INVOLVED, AND COMPLIANCE WITH OTHER PROVISIONS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR REFUND OF RETIREMENT DEDUCTIONS (CSRS) SF 2802

  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 60,000 0 0 0 60,000 0
Annual Time Burden (Hours) 60,000 0 0 0 60,000 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.
04/17/1990


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