Ri 20-64 Ss

OMB SUPPORTING STATEMENT

RI 20-64 - Letter Reply to Request for Information

RI 20-64A - Former Spouse Survivor Annuity Election

RI 20-64B - Information on Electing a Survivor Annuity for Your Former Spouse

1. Justification

1. Title 5, U. S. Code, Section 8339(j)(3) and Section 8417 state that annuitants may elect, after retirement, to provide survivor annuity benefits for a former spouse.

2. RI 20-64 is used by the Civil Service Retirement System to provide information about the amount of annuity payable after a survivor reduction, to explain the annuity reductions required to pay for the survivor benefit, and to give the beginning rate of survivor annuity. RI 20-64A, the election form, and RI 20-64B, an information booklet, are enclosed. This group of forms is needed to obtain an informed survivor benefits election from annuitants who are eligible to elect to provide survivor benefits for a former spouse. Using RI 20-64A, the annuitant may elect the survivor benefit, obtain any current spouse’s consent to the election, or decline to make the election. RI 20-64 has a space the annuitant may use to ask for information about electing less than the maximum survivor benefit. OPM could not comply with title 5 if this information were not collected. The Public Burden Statement meets the requirement of 5 CFR 1320.8(b)(3).

2. New methods of information technology would do little to reduce the burden on the respondents. They must sign the election form. This form is available in a PDF fillable format on our website and meets our GPEA requirements.

2. Elections are filed individually. Similar information certified by the respondent is not available. Duplication is minimized.

2. Information is not collected from small businesses.

2. If this information were not collected, annuitants would be unable to elect survivor benefits provided by law.

2. This information collection is consistent with the guidelines in 5 CFR 1320.6.

2. A notice of proposed information collection was published in the Federal Register on January 23, 2014, giving persons outside the agency an opportunity to comment on the form. No comments were received.

2. No payment or gift is provided to these respondents.

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2. 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).

2. 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.

2. We estimate that 30 survivor elections on RI 20-64A will be processed per year and that of these 8 will use RI 20-64 to ask for information about electing a smaller survivor benefit. Form RI 20-64A requires 45 minutes to complete for a burden of 23 hours. Form RI 20-64 requires 8 minutes to complete for a burden of one hour. The total burden is 24 hours.

2. There is no cost to the respondent.

2. The annualized cost to the Federal government is $1,412. This cost includes employee salary hours devoted to the program, forms cost, and overhead.

2. There is no change in the respondent burden.

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

2. 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.

2. There are no exceptions to the certification statement.