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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0156 can be found here:

Documents and Forms

Document Name Document Type
Form SF-2800 Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When Deceased Was an... Form and Instruction
SF-2800 Application for Death Benefits under the Civil Service R SF2800(12-08).pdf Form and Instruction
SF-2800A Documentation and Elections in Support of Application fo SF 2800A.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Death Benefits Under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When Deceased Was an...	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 Ch. 1, Sec. 831 - Subpart F (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SF-2800	Application for Death Benefits under the Civil Service Retirement System (CSRS)	SF2800(12-08).pdf		No		Fillable Printable
Form and Instruction	SF-2800A	Documentation and Elections in Support of Application for Death Benefits When Deceased Was an Employee at the Time of Death	SF 2800A.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: 74,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	74,800	18,700	56,100
Annual IC Time Burden (Hours)	56,100	0	56,100
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.