RI 25-7, Marital Status Certification Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form RI 25-7 Marital Status Certification Survey	Form and Instruction	Modified	Available
60-day FRN.pdf	Supplementary Document	Uploaded 2009-07-01	Available
30-day FRN.pdf	Supplementary Document	Uploaded 2009-07-01	Available
RI 25-7 SS.doc	Supporting Statement A	Uploaded 2009-07-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
33548	Marital Status Certification Survey	Form and Instruction	Modified

ICR Details

OMB Control No: 3206-0033	ICR Reference No: 200907-3206-001
Status: Historical Active	Previous ICR Reference No: 200811-3206-001
Agency/Subagency: OPM	Agency Tracking No:
Title: RI 25-7, Marital Status Certification Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/29/2009
	Date Received in OIRA: 07/01/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2012	36 Months From Approved	07/31/2009
Responses	24,000	0	2,500
Time Burden (Hours)	6,000	0	625
Cost Burden (Dollars)	0	0	0

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Abstract: RI 25-7 is used to determine whether widows, widowers, and former spouses receiving survivor annuities from OPM have remarried before reaching age 55 and, thus, are no longer eligible for benefits from us.

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Authorizing Statute(s): US Code: 5 USC 8442 Name of Law: Rights of a Widow, Widower
   US Code: 5 USC 8445 Name of Law: Rights of a Former Spouse
   US Code: 5 USC 8341 Name of Law: Survivor Annuities
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 14170	03/30/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 31470	07/01/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Marital Status Certification Survey	RI 25-7	Marital Status Certification Survey

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ICR Summary of Burden

table that charts list of burden

	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	24,000	2,500	0	21,500	0	0
Annual Time Burden (Hours)	6,000	625	0	5,375	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The respondent burden increased by 5,375 hours because in 2009 OPM requires a response from each person surveyed. In the past the only respondents were those who had married and had not yet informed OPM. In order to be certain to obtain an accurate result from the 2009 marital status survey, OPM is requiring each person surveyed to respond. OPM management goal is to change to a web-based survey. We need to be able to compare the results of the 2009 survey with surveys performed in earlier years to look for consistency. After this base line is determined and the change to a web-based survey is made, a decision can be made as to whether to revert to requiring a response only from those who have married and have not yet informed OPM.

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Annual Cost to Federal Government: $77,950

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/01/2009

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