Evidence to Prove Dependency of a Child

ICR 200812-3206-001

OMB: 3206-0206

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2008-12-17
IC Document Collections
IC ID
Document
Title
Status
33698 Modified
ICR Details
3206-0206 200812-3206-001
Historical Active 200503-3206-002
OPM
Evidence to Prove Dependency of a Child
Revision of a currently approved collection   No
Regular
Approved without change 04/06/2009
Retrieve Notice of Action (NOA) 12/31/2008
  Inventory as of this Action Requested Previously Approved
04/30/2012 36 Months From Approved 04/30/2009
250 0 250
250 0 250
0 0 0

RI 25-37 is designed to collect sufficient information for the Retirement Services Program to be able to determine whether the surviving child of a deceased Federal employee is eligible to receive benefits as a dependent child.

US Code: 5 USC 8341(a)(3) Name of Law: Survivor Annuities (CSRS)
   US Code: 5 USC 8441(3) Name of Law: Survivor Annuities (FERS)
  
None

Not associated with rulemaking

  73 FR 7613 02/08/2008
73 FR 58683 10/07/2008
No

1
IC Title Form No. Form Name
Evidence to Prove Dependency of a Child

  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 250 250 0 0 0 0
Annual Time Burden (Hours) 250 250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$4,900
No
Yes
Uncollected
Uncollected
No
Uncollected
Cyrus Benson 202 606-0623 [email protected]

  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.
12/31/2008


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