SF 2817, Life Insurance Election, is
used by Federal employees and assignees (those who have acquired
ownership and control of an employee's or annuitant's coverage
through the enrollee's assignment of life insurance). The form is
used as the official agency record of the individual's coverage and
enrollment status under the FEGLI program, and as acknowledgment
and authorization by the individual for collection from him or her
of the enrollee share of the premium contributions.
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.