Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When Deceased Was an...

ICR 200508-3206-002

OMB: 3206-0156

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
3206-0156 200508-3206-002
Historical Active 200203-3206-001
OPM
Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When Deceased Was an...
Revision of a currently approved collection   No
Regular
Approved without change 10/07/2005
Retrieve Notice of Action (NOA) 08/02/2005
  Inventory as of this Action Requested Previously Approved
10/31/2008 10/31/2008 10/31/2005
56,100 0 74,800
56,100 0 56,100
0 0 0

SF 2800 is needed to collect information so that OPM can pay death benefits to the survivors of Federal employees and annuitants. SF 2800A is needed for deaths in service only so that survivors can make the needed election regarding military service.

None
None


No

  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 56,100 74,800 0 -18,700 0 0
Annual Time Burden (Hours) 56,100 56,100 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.
08/02/2005


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