Information Collection

Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)

IC 33600 under ICR 201004-3206-019 · OMB 3206-0136.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0136 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF 2823 Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)	Form and Instruction
SF 2823 Designation of Beneficiary, Federal Employees Group Life SF2823_May2010.pdf	Form and Instruction
SF2823_May2010_MarkUp.pdf SF 2823 May 2010 Markup	IC Document
SF2823_July2003_MarkUp.pdf SF 2823 July 2003 Markup	IC Document

IC Title:

Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 870.909 5 CFR 870.802

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 2823	Designation of Beneficiary, Federal Employees Group Life Insurance (FEGLI) Program	SF2823_May2010.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: 48,000

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	48,000	48,000
Annual IC Time Burden (Hours)	12,000	12,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SF 2823 May 2010 Markup	SF2823_May2010_MarkUp.pdf	04/22/2010
SF 2823 July 2003 Markup	SF2823_July2003_MarkUp.pdf	04/22/2010

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