Opm 1523

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0262 can be found here:

Documents and Forms

Document Name Document Type
Form OPM 1523 OPM 1523 Form and Instruction
OPM 1523 Supplemental Semiannual Headcount Report opm1523.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	OPM 1523	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OPM 1523	Supplemental Semiannual Headcount Report	opm1523.pdf		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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