Information Collection

Financial Resources Questionnaires, Notices of Amount Due Because of Annuity Overpayment

IC 33642 under ICR 200910-3206-001 · OMB 3206-0167.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0167 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI 34-1 Financial Resources Questionnaires, Notices of Amount Due Because of Annuity Overpayment	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_March2008.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because of Annuity Overpayment RI34-003_March2008.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire, FEGLI Premiums Underp RI 34-17(12-08).pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI34-19.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire FEHB Premiums Underpai RI 34-18.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI 34-20 October 2009.pdf	Form and Instruction
RI34-1_MarkUp.pdf RI 34-1 Markup	IC Document
RI34-3_MarkUp.pdf RI 34-3 Markup	IC Document
RI34-19 Markup.pdf RI 34-19 Markup	IC Document
RI34-003 differences.pdf RI 34-3 differences	IC Document
Nonsubstantive change NOA.pdf NOA	IC Document
RI 34-18 October 2009 Mark up.pdf RI 34-18 October 2009 Mark up	IC Document
RI 34-20 October 2009 Markup.pdf RI 34-20 October 2009 Mark up	IC Document

IC Title:

Financial Resources Questionnaires, Notices of Amount Due Because of Annuity Overpayment

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 845 5 CFR 831 Subpart M and N

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	RI 34-1	Financial Resources Questionnaire	RI34-001_March2008.pdf	No	Fillable Printable
Form and Instruction	RI 34-3	Notice of Amount Due Because of Annuity Overpayment	RI34-003_March2008.pdf	No	Fillable Printable
Form and Instruction	RI 34-17	Financial Resources Questionnaire, FEGLI Premiums Underpaid	RI 34-17(12-08).pdf	No	Fillable Printable
Form and Instruction	RI 34-19	Notice of Amount Due Because of FEGLI Premium Underpayment	RI34-19.pdf	No	Fillable Printable
Form and Instruction	RI 34-18	Financial Resources Questionnaire FEHB Premiums Underpaid	RI 34-18.pdf	No	Fillable Printable
Form and Instruction	RI 34-20	Notice of Amount Due Because of FEHB Premium Underpayment	RI 34-20 October 2009.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: 2,081

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	Previously Approved
Annual Number of Responses for this IC	2,081	2,081
Annual IC Time Burden (Hours)	2,081	2,081
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
RI 34-1 Markup	RI34-1_MarkUp.pdf	06/02/2009
RI 34-3 Markup	RI34-3_MarkUp.pdf	06/02/2009
RI 34-19 Markup	RI34-19 Markup.pdf	06/25/2009
RI 34-3 differences	RI34-003 differences.pdf	06/25/2009
NOA	Nonsubstantive change NOA.pdf	06/25/2009
RI 34-18 October 2009 Mark up	RI 34-18 October 2009 Mark up.pdf	10/27/2009
RI 34-20 October 2009 Mark up	RI 34-20 October 2009 Markup.pdf	10/27/2009

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