Sf 2812a

Report of Withholdings and Contributions for Health Benefits, Life Insurance and Retirement

OMB: 3206-0262

IC ID: 209210

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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SF 2812A
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SF 2812A Report of Withholdings and Contributions for Health Benefits by Enrollment Code sf2812a.pdf Yes Yes Fillable Printable

General Government Central Personnel

 

100 0
   
Federal Government
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,600 0 2,600 0 0 0
Annual IC Time Burden (Hours) 1,300 0 1,300 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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