Information Collection

SF 3102, Designation of Beneficiary (FERS)

IC 33655 under ICR 201112-3206-001 · OMB 3206-0173.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0173 can be found here:

Documents and Forms

Document Name Document Type
Form SF 3102 SF 3102, Designation of Beneficiary (FERS) Form and Instruction
SF 3102 Designation of Beneficiary (FERS) SF3102_December2011.pdf Form and Instruction
SF3102_December2011 Markup.pdf SF3102_December2011 Markup IC Document
SF3102 (12-06) Markup.pdf SF3102 (12-06) Markup IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SF 3102, Designation of Beneficiary (FERS)	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 843.203 - 843.205

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SF 3102	Designation of Beneficiary (FERS)	SF3102_December2011.pdf		Yes	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: 3,888	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,888	778	3,110
Annual IC Time Burden (Hours)	972	195	777
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
SF3102_December2011 Markup	SF3102_December2011 Markup.pdf	12/12/2011
SF3102 (12-06) Markup	SF3102 (12-06) Markup.pdf	12/12/2011

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