By this action,
OMB approves the instructions to accompany the Form 2809-EZ1. The
approval of material by OMB on 8/27/91 is is not affected by this
action. Both the form and the instructions, therefore, have the
common expiration date of 8/31/92. In the future, all requests for
OMB approval that revise earlier approved requests should contain
all of the material the agency wishes to be approved for current
use (In this case a copy of the form should have accompanied this
request).
Inventory as of this Action
Requested
Previously Approved
08/31/1992
08/31/1992
08/31/1992
127,913
0
127,913
63,957
0
63,957
0
0
0
OPM FORM 2809-EZ1 IS USED ONLY AT OPEN
SEASON TO REQUEST DESCRIPTIONS PLANS THE ENROLLEE IS CONSIDERING OR
TO ELECT TO CHANGE PLANS. IF OPM FORM 2809-EZ1 IS USED TO REQUEST
PLAN INFORMATION, OPM FORM 2809-EZ2 IS FURNISHED THE ENROLLEE FOR
IS A PLAN CHANGE IS DESIRED.
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.