Information Collection

SF 3102, Designation of Beneficiary (FERS)

IC 33655 under ICR 200903-3206-002 · OMB 3206-0173.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0173 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3102 SF 3102, Designation of Beneficiary (FERS)	Form and Instruction
3102 Designation of Beneficiary, Federal Employees Retirement SF3102 (12-06) 508.pdf	Form and Instruction

IC Title:

SF 3102, Designation of Beneficiary (FERS)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 843.203 - 843.205

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3102	Designation of Beneficiary, Federal Employees Retirement System	SF3102 (12-06) 508.pdf		No		Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title: OPM/Central-1

FR Citation: 73 FR 15013

Number of Respondents: 3,110

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,110	217	2,893
Annual IC Time Burden (Hours)	777	54	723
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.