Ri 25-15 Ss

OMB SUPPORTING STATEMENT

RI 25-15 – Survey of Student’s Eligibility to Receive Benefits

A. Justification

1. Title 5, U. S. Code, Chapter 83, Section 8341(a)(4) and Chapter 84, Section 8441(4) provide that the Office of Personnel Management (OPM) shall determine the continuing eligibility of unmarried, dependent student children between the ages of 18 and 22 to receive survivor annuity benefits. RI 25-15 is used in February and October of each year to collect information from students regarding marital status, current and future plans for full-time school attendance and to verify that the student has continued the school attendance previously certified to OPM on RI 25-14, Self-Certification of Full-Time School Attendance (3602-0032). Only individuals whose benefits should stop are requested to return the form.

2. RI 25-15 is designed to give students an opportunity to inform OPM if they are not or will not be entitled to continue to receive survivor benefits. If this information were not collected, we might continue to pay benefits to persons who are no longer entitled. The form has been revised to bring it up-to-date. The Public Burden Statement meets the requirements of 5 CFR 1320.8(b)(3).

3. The information collected is detailed and can only be obtained from the respondents. New methods of information technology would do little to reduce the burden on the respondents; they must sign certifying the truth of their statements, under penalty of law. However, this form is available in a PDF fillable format on our website and meets our GPEA requirements.

4. Certifications are filed individually because this information is not available elsewhere. Duplication is minimized.

5. Information is not collected from small businesses.

6. The collection of this information is performed twice each year. Less frequent collection would cause OPM to pay persons who may no longer be eligible.

7. The collection is consistent with the guidelines in 5 CFR 1320.6, except 1320.6(b). A response is required within 30 days in order to prevent payments to survivor annuitants who are no longer eligible.

8. A notice of proposed information collection was published in the Federal Register on August 15, 2012, as required by 5 CFR 1320, giving persons outside the agency an opportunity to comment on the form. No comments were received.

9. No payment or gift is provided to respondents.

Page 2

10. This information collection is protected by the Privacy Act of 1974 and OPM regulations (5 CFR 831.106). The routine uses for disclosure appear in the Federal Register for OPM/Central-1 (73 FR 15013, et seq., March 20, 2008).

11. This information collection does not include questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.

12. We estimate 2,500 certifications will be processed annually. The forms take about 20 minutes to respond for an annual burden of 835 hours. A response is needed only if the student’s status has or will change.

13. There is no cost to the beneficiary.

14. The annualized cost to the Federal government is $43,900. This cost was determined by employee salary hours devoted to the program, forms cost, and overhead.

15. There are no changes to the respondent burden.

16. The results of this information collection are not published.

17. It is not cost effective to reprint the whole supply of forms to change the OMB clearance expiration date. Therefore, we seek approval not to display the date on the form.

18. There are no exceptions to the certification statement.