ANNUITY SUPPLEMENT EARNINGS REPORT

ICR 199408-3206-001

OMB: 3206-0194

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
157077 Migrated
ICR Details
3206-0194 199408-3206-001
Historical Active 199109-3206-002
OPM
ANNUITY SUPPLEMENT EARNINGS REPORT
Revision of a currently approved collection   No
Regular
Approved without change 11/01/1994
Retrieve Notice of Action (NOA) 08/18/1994
  Inventory as of this Action Requested Previously Approved
10/31/1997 10/31/1997 10/31/1994
1,500 0 3,000
375 0 750
0 0 0

THE ANNUITY SUPPLEMENT EARNINGS REPORT, RI 92-22, IS USED TO ANNUALLY OBTAIN THE AMOUNT OF PERSONAL EARNINGS FROM ANNUITY SUPPLEMENT RECIPIENTS TO DETERMINE IF THERE SHOULD BE A REDUCTION IN BENEFITS PAI TO THE ANNUITANT.

None
None


No

1
IC Title Form No. Form Name
ANNUITY SUPPLEMENT EARNINGS REPORT RI 92-22

  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 1,500 3,000 0 0 -1,500 0
Annual Time Burden (Hours) 375 750 0 0 -375 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.
08/18/1994


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