Information Collection

Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay

IC 19621 under ICR 201409-1545-012 · OMB 1545-1920.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1920 can be found here:

Documents and Forms

Document Name Document Type
Form 12311 Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay Form
12311 Repayment of a Federal Government Buyout and Possible Su f12311--2005.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay	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 550.710 5 CFR 550.771

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	12311	Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay	f12311--2005.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,624	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,624	-26,461	33,085
Annual IC Time Burden (Hours)	530	-2,227	2,757
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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