Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits

ICR 201010-3206-006

OMB: 3206-0233

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2010-10-14
Supplementary Document
2010-10-14
Supporting Statement A
2010-10-14
ICR Details
3206-0233 201010-3206-006
Historical Active 200711-3206-004
OPM
Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits
Revision of a currently approved collection   No
Regular
Approved without change 04/08/2011
Retrieve Notice of Action (NOA) 11/02/2010
  Inventory as of this Action Requested Previously Approved
04/30/2014 36 Months From Approved 04/30/2011
34,800 0 34,800
17,400 0 17,400
0 0 0

RI 25-51 is used to collect information from survivors of deceased annuitants who retired under the Civil Service Retirement System. This form is used only for survivors who are already identified in OPM records as payable when the annuitants dies.

US Code: 5 USC 8341 Name of Law: Survivor Annuitants
   US Code: 5 USC 8342 Name of Law: Lump-Sum Benefits; Designation of Beneficiaries; Order of Precedence
  
None

Not associated with rulemaking

  75 FR 28305 05/20/2010
75 FR 61783 10/06/2010
No

  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 34,800 34,800 0 0 0 0
Annual Time Burden (Hours) 17,400 17,400 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$531,200
No
No
No
No
No
Uncollected
Miles Windsor 202 606-8358 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/02/2010


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