Information Collection

Application for Deferred Retirement (Separations on or after October 1, 1956)

IC 33585 under ICR 201012-3206-004 · OMB 3206-0121.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0121 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OPM 1496A Application for Deferred Retirement (Separations on or after October 1, 1956)	Form and Instruction
OPM 1496A Application for Deferred Retirement (Separations Before OPM1496A.pdf	Form and Instruction
OPM 1496A April 2008 Markup.pdf OPM 1496A April 2008 Markup	IC Document
OPM 1496A Dec 2010 Markup.pdf OPM 1496A Dec 2010 Markup	IC Document

IC Title:

Application for Deferred Retirement (Separations on or after October 1, 1956)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 831.501

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	OPM 1496A	Application for Deferred Retirement (Separations Before October 1, 1956)	OPM1496A.pdf		No		Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title: OPM/Central-1

FR Citation: 73 FR 15013

Number of Respondents: 2,800

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	2,800	2,800
Annual IC Time Burden (Hours)	2,800	2,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OPM 1496A April 2008 Markup	OPM 1496A April 2008 Markup.pdf	12/20/2010
OPM 1496A Dec 2010 Markup	OPM 1496A Dec 2010 Markup.pdf	12/20/2010

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