Sf 3102 Ss

OMB SUPPORTING STATEMENT

SF 3102, Designation of Beneficiary – (FERS)

1. Justification

1. The Federal Employees Retirement System Act of 1986 (PL 99-335),

provides that a Federal employee or an annuitant may designate a beneficiary to receive any lump sum payment due from the Federal Employees Retirement System (FERS) in the event of death. SF 3102, Designation of Beneficiary (FERS), is the document which is used to establish the designation.

2. This information is used by the Office of Personnel Management,

Federal Employees Retirement System, in determining the proper payee in the event of death. If SF 3102 is not on file, the lump sum is paid according to the order of precedence (5 USC 8424(d)) shown in the instructions on the form.

3. Use of improved information technology to reduce the burden is not

practical. The information collection is voluntary and must be made in writing. The form is available in PDF fillable format on our electronic forms page at www.opm.gov/forms.

4. All designations are filed individually for FERS. Designations of

Beneficiary for other systems cannot be used for FERS. Even though the designations may be similar for each system, they all require designations specifically for that system.

5. This information collection does not involve small businesses or other

small entities.

6. This information collection cannot be made less frequently because it

is filed at the employee’s or annuitant’s option.

7. This information collection is consistent with the guidelines in

5 CFR 1320.6.

8. A 60 day notice of proposed information collection was published in the

Federal Register on June 7, 2011, as required by 5 CFR 1320, offering persons outside the agency an opportunity to comment on the form. No comments were received. A 30-day notice will be published in the Federal Register with this submission.

9. No gift or payment is awarded respondents based on return of the form.

10. This information collection is protected by the Privacy Act of 1974 and

OPM regulations (5 CFR 841.108). The routine uses of disclosure appear in the Federal Register for OPM/Central-1 (73 FR 15013, et seq., March 20, 2008).

11. There are no questions of a sensitive nature, such as sexual behavior and

attitudes, religious beliefs, and other matters that are commonly considered private.

12. The number of annuitants responding per year is expected to increase as

more people retire under FERS. Current use should not exceed 3888 responses per year at 15 minutes each to complete. The annual burden is 972 hours. These estimates have increased over our previous estimates of 3110 responses per year, with an annual burden of 777.5 hours. Response time is not expected to vary substantially.

13. There is no recordkeeping burden.

14. Annualized cost to the Federal Government is approximately $15,124.32.

This cost is derived from employee salaries, staff hours required to process the forms and the cost of printing, storing and shipping forms. The cost to respondents is minimal.

15. Respondent burden has changed from previously reported burden, since

the number of individuals covered under FERS continues to increase.

15. There are no plans for tabulation and publication of this information

collection.

15. The OMB approval expiration date is not included on the form, because it

tends to confuse applicants using the form and it is not cost effective to reprint forms to change the expiration date.

15. There are no exceptions to the certification statement identified in Item 19

of OMB Form 83-I.