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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0233 can be found here:

Documents and Forms

Document Name Document Type
Form RI 25-51 Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits Form and Instruction
RI 25-51 Civil Service Retirement System Survivor Annuitant Expre RI25-051_December2010_Updated.pdf Form and Instruction
RI 25-051 March 2005 Markup.pdf RI 25-051 March 2005 MarkUp IC Document
RI25-051_December2010_Updated_MarkUp.pdf RI25-051_December2010_Updated_MarkUp IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits	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 and Instruction	RI 25-51	Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits	RI25-051_December2010_Updated.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: 34,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	34,800	34,800
Annual IC Time Burden (Hours)	17,400	17,400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
RI 25-051 March 2005 MarkUp	RI 25-051 March 2005 Markup.pdf	10/14/2010
RI25-051_December2010_Updated_MarkUp	RI25-051_December2010_Updated_MarkUp.pdf	10/14/2010

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