Annuity Supplement Earnings Report

ICR 200003-3206-008

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
33677 Migrated
ICR Details
3206-0194 200003-3206-008
Historical Active 199611-3206-001
OPM
Annuity Supplement Earnings Report
Extension without change of a currently approved collection   No
Regular
Approved without change 09/07/2000
Retrieve Notice of Action (NOA) 03/09/2000
This request--as amended by additional clarifying material dated 6/26/00--provided to OMB is approved.
  Inventory as of this Action Requested Previously Approved
02/29/2004 02/29/2004 09/30/2000
180 0 160
45 0 40
0 0 0

The Annuity Supplement Earnings Report, RI 92-22, is used annually to obtain the amount of personal earnings from annuity supplement recipients to determine if there should be a reduction in benefits paid 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 180 160 0 0 20 0
Annual Time Burden (Hours) 45 40 0 0 5 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.
03/09/2000


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