Marital Information Required of Refund Applicants

ICR 200105-3206-002

OMB: 3206-0213

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
33711 Migrated
ICR Details
3206-0213 200105-3206-002
Historical Active 199712-3206-003
OPM
Marital Information Required of Refund Applicants
Revision of a currently approved collection   No
Regular
Approved without change 07/23/2001
Retrieve Notice of Action (NOA) 05/18/2001
  Inventory as of this Action Requested Previously Approved
07/31/2004 07/31/2004 07/31/2001
2,600 0 100
1,300 0 50
0 0 0

In order to pay refunds of retirement contributions, OPM must know about the applicant's marital status and whether any spouse and/or former spouse(s) have been informed of the proposed refund. All applicants for refund must respond.

None
None


No

1
IC Title Form No. Form Name
Marital Information Required of Refund Applicants RI-95-4

  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 2,600 100 0 0 2,500 0
Annual Time Burden (Hours) 1,300 50 0 0 1,250 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.
05/18/2001


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