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

OPM 1496A, Application for Deferred Retirement (Separations on or after October 1, 1956)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form OPM 1496A Application for Deferred Retirement (Separations on or after October 1, 1956) Form and Instruction
OPM 1496A CSRS Application for Deferred Retirement (For persons se OPM 1496A March 2012.pdf Form and Instruction
OPM 1496A December 2010 markup.pdf OPM 1496A December 2010 Markup IC Document
OPM 1496A March 2012 Markup.pdf OPM 1496A March 2012 Markup IC Document

Information Collection (IC) Details

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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OPM 1496A	CSRS Application for Deferred Retirement (For persons separated on or after October 1, 1956)	OPM 1496A March 2012.pdf		Yes	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 %

	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

Title	Document	Date Uploaded
OPM 1496A December 2010 Markup	OPM 1496A December 2010 markup.pdf	12/12/2011
OPM 1496A March 2012 Markup	OPM 1496A March 2012 Markup.pdf	12/12/2011

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