Information Collection

Application For Survivor Death Benefits

IC 157342 under ICR 199308-3220-001 · OMB 3220-0031.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0031 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR SURVIVOR DEATH BENEFITS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	AA-11A,	No	No
Form	AA-21,	No	No
Form	G-131,	No	No
Form	G-273A	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,570	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	24,170	24,170
Annual IC Time Burden (Hours)	8,964	8,964
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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