Evidence to Prove Dependency of a Child

ICR 199807-3206-003

OMB: 3206-0206

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
33696 Migrated
ICR Details
3206-0206 199807-3206-003
Historical Active 199412-3206-003
OPM
Evidence to Prove Dependency of a Child
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 08/26/1998
Retrieve Notice of Action (NOA) 07/06/1998
  Inventory as of this Action Requested Previously Approved
08/31/2001 08/31/2001
250 0 0
250 0 0
0 0 0

RI 25-37 is designed to collect sufficient information for the Retirement and Insurance Service to be able to determine whether the surviving child of a deceased Federal employee is eligible to receive benefits as a dependent child.

None
None


No

1
IC Title Form No. Form Name
Evidence to Prove Dependency of a Child RI-25-37

  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 250 0 0 250 0 0
Annual Time Burden (Hours) 250 0 0 250 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.
07/06/1998


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