Information Collection

CSRS/FERS Documentation in Support of Disability Retirement Application

IC 33732 under ICR 201004-3206-011 · OMB 3206-0228.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0228 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF 3112 CSRS/FERS Documentation in Support of Disability Retirement Application	Form and Instruction
SF 3112 Documentation in Support of Disability Retirement Applic SF3112_December2009_Updated.pdf	Form and Instruction
SF3112_December2009_Updated_MarkUp.pdf SF 3112 December 2009 Markup	IC Document
SF3112_Feb_2004 Markup.pdf SF3112 Feb 2004 Markup	IC Document
SF3112-1.pdf SF3112-1	IC Document
SF3112-2.pdf SF3112-2	IC Document

IC Title:

CSRS/FERS Documentation in Support of Disability Retirement Application

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 844 Subpart C 5 CFR 831 Subpart L

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	SF 3112	Documentation in Support of Disability Retirement Application	SF3112_December2009_Updated.pdf		No		Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title: OPM/Central-1

FR Citation: 73 FR 15013

Number of Respondents: 13,450

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	13,450	13,450
Annual IC Time Burden (Hours)	12,775	12,775
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SF 3112 December 2009 Markup	SF3112_December2009_Updated_MarkUp.pdf	04/15/2010
SF3112 Feb 2004 Markup	SF3112_Feb_2004 Markup.pdf	04/15/2010
SF3112-1	SF3112-1.pdf	04/15/2010
SF3112-2	SF3112-2.pdf	04/15/2010

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