MARITAL INFORMATION REQUIRED OF REFUND APPLICANTS

ICR 199305-3206-003

OMB: 3206-0213

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
157122 Migrated
ICR Details
3206-0213 199305-3206-003
Historical Active
OPM
MARITAL INFORMATION REQUIRED OF REFUND APPLICANTS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/22/1993
Retrieve Notice of Action (NOA) 05/13/1993
Approved, as amended by changes submitted by OPM on 7-22-93.
  Inventory as of this Action Requested Previously Approved
06/30/1996 06/30/1996
32,400 0 0
16,200 0 0
0 0 0

IN ORDER TO PAY REFUNDS OF RETIREMENT CONTRIBUTIONS, OPM MUST KNOW ABO THE APPLICANT'S MARITAL STATUS AND WHETHER ANY SPOUSE AND ANY FORMER SPOUSES HAVE BEEN INFORMED OF THE PROPOSED FUND. ALL APPLICANTS FOR REFUND MUST RESPOND.

None
None


No

1
IC Title Form No. Form Name
MARITAL INFORMATION REQUIRED OF REFUND APPLICANTS RI 95-4

  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 32,400 0 0 32,400 0 0
Annual Time Burden (Hours) 16,200 0 0 16,200 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.
05/13/1993


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