Court Orders Affecting Retirement Benefits - 5 CFR Sections 838.221, 838.421, and 838.721

ICR 200203-3206-004

OMB: 3206-0204

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
3206-0204 200203-3206-004
Historical Active 199807-3206-001
OPM
Court Orders Affecting Retirement Benefits - 5 CFR Sections 838.221, 838.421, and 838.721
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 03/29/2002
Retrieve Notice of Action (NOA) 03/21/2002
  Inventory as of this Action Requested Previously Approved
06/30/2005 06/30/2005
19,000 0 0
9,500 0 0
0 0 0

5 CFR 838.221, 838.421, and 838.721 require former spouses of Federal employees to write to OPM, providing specific information needed for OPM to make court-ordered benefit payments. This information is needed to identify affected employees and to certify that the court order remains in effect.

None
None


No

1
IC Title Form No. Form Name
Court Orders Affecting Retirement Benefits - 5 CFR Sections 838.221, 838.421, and 838.721

  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 19,000 0 0 19,000 0 0
Annual Time Burden (Hours) 9,500 0 0 9,500 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.
03/21/2002


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