Information Collection

SF 3102, Designation of Beneficiary (FERS)

IC 33655 under ICR 201501-3206-003 · OMB 3206-0173.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0173 can be found here:

Documents and Forms

Document Name Document Type
Form SF 3102 SF 3102, Designation of Beneficiary (FERS) Form and Instruction
SF 3102 Designation of Beneficiary (FERS) SF3102_December2011.pdf Form and Instruction
SF3102_December2011 Markup.pdf SF3102_December2011 Markup IC Document
SF3102 (12-06) Markup.pdf SF3102 (12-06) Markup IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SF 3102, Designation of Beneficiary (FERS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 843.203 - 843.205

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SF 3102	Designation of Beneficiary (FERS)	SF3102_December2011.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM/Central-1	FR Citation: 73 FR 15013

Number of Respondents: 3,888	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,888	3,888
Annual IC Time Burden (Hours)	972	972
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SF3102_December2011 Markup	SF3102_December2011 Markup.pdf	12/12/2011
SF3102 (12-06) Markup	SF3102 (12-06) Markup.pdf	12/12/2011

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