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

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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 Li SF2823_February2011.pdf Form and Instruction
SF2823_February2011_MarkUp.pdf SF2823_February2011_Markup IC Document
SF2823_May2010 Markup.pdf SF2823_May2010 Markup IC Document

Information Collection (IC) Details

View Information Collection (IC)

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:

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	SF2823_February2011.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 %

	Approved	Change Due to Potential Violation of the PRA
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

Title	Document	Date Uploaded
SF2823_February2011_Markup	SF2823_February2011_MarkUp.pdf	12/20/2010
SF2823_May2010 Markup	SF2823_May2010 Markup.pdf	12/20/2010

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