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RI 38-117, Rollover Election
RI 38-117, Rollover Election, RI 37-118, Rollover Information, and RI 37-22, Special Tax Notice Regarding Rollovers
OMB: 3206-0212
IC ID: 33708
OMB.report
OPM
OMB 3206-0212
ICR 201008-3206-001
IC 33708
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0212 can be found here:
2022-07-27 - Extension without change of a currently approved collection
2019-05-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form RI 38-117
RI 38-117, Rollover Election
Form
RI 38-117 Rollover Election Form
RI 38-117 July 2010.pdf
Form
RI 38-118 Rollover Information
RI38-118_September2010.pdf
Form and Instruction
RI 37-22 Special Tax Notice Regarding Rollovers
RI 37-22 July 2010.pdf
Form and Instruction
RI 38-117 Markups.pdf
RI 38-117 Markups
IC Document
RI38-118_September2010_MarkUp.pdf
RI38-118_September2010_Markup
IC Document
RI38-118_September2009 Markup.pdf
RI38-118_September2009 Markup
IC Document
RI 37-22 July 2010 and April 2009 markups.pdf
RI 37-22 July 2010 and April 2009 markups
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
RI 38-117, Rollover Election
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
RI 38-117
Rollover Election Form
RI 38-117 July 2010.pdf
No
Fillable Printable
Form and Instruction
RI 38-118
Rollover Information
RI38-118_September2010.pdf
No
Fillable Printable
Form and Instruction
RI 37-22
Special Tax Notice Regarding Rollovers
RI 37-22 July 2010.pdf
No
Printable Only
Federal Enterprise Architecture Business Reference Module
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:
1,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,500
0
0
0
0
1,500
Annual IC Time Burden (Hours)
1,000
0
0
0
0
1,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
RI 38-117 Markups
RI 38-117 Markups.pdf
08/10/2010
RI38-118_September2010_Markup
RI38-118_September2010_MarkUp.pdf
08/10/2010
RI38-118_September2009 Markup
RI38-118_September2009 Markup.pdf
08/10/2010
RI 37-22 July 2010 and April 2009 markups
RI 37-22 July 2010 and April 2009 markups.pdf
08/10/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.