CSRS/FERS Documentation in Support of Disability Retirement Application

ICR 200402-3206-002

OMB: 3206-0228

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
3206-0228 200402-3206-002
Historical Active 200008-3206-005
OPM
CSRS/FERS Documentation in Support of Disability Retirement Application
Revision of a currently approved collection   No
Regular
Approved without change 05/28/2004
Retrieve Notice of Action (NOA) 02/23/2004
  Inventory as of this Action Requested Previously Approved
05/31/2007 05/31/2007 05/31/2004
13,450 0 12,775
12,775 0 12,775
0 0 0

SF 3112 collects information from applicants for disability retirement so that OPM can determine whether to approve a disability retirement.

None
None


No

1
IC Title Form No. Form Name
CSRS/FERS Documentation in Support of Disability Retirement Application SF-3112

  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 13,450 12,775 0 675 0 0
Annual Time Burden (Hours) 12,775 12,775 0 0 0 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.
02/23/2004


© 2024 OMB.report | Privacy Policy