OMB SUPPORTING STATEMENT 1153 30 day2015

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OMB SUPPORTING STATEMENT

SF 1153-Claim for Unpaid Compensation of Deceased Civilian Employee

1. Justification

1. Pursuant to the Legislative Branch Appropriations Act of 1996, most of the claims settlement functions performed by the General Accounting Office, now known as the Government Accountability Office (GAO), were transferred to the Director, Office of Management and Budget. See Sec. 211, Pub.L. 104-53, 109 Stat. 535. Subsequently, the Acting Director delegated these functions to various components within the Executive Branch in a determination order dated June 28, 1996. In summary, this order delegated to the U.S. Office of Personnel Management (OPM) the authority to settle claims against the United States involving Federal civilian employees’ compensation and leave, deceased employees’ compensation, and proceeds of cancelled checks for veterans’ benefits payable to deceased beneficiaries. Congress then codified these changes through additional legislation. See Pub.L. 104-316, 110 Stat. 3826. OPM promulgated regulations at title 5, Code of Federal Regulations (CFR), part 178, setting forth detailed procedures for settling claims.

2. Specifically, 5 CFR 178.205(a) directs that the agency at which the deceased employee was last employed request the appropriate person or persons to execute Standard Form (SF) 1153, Claim for Unpaid Compensation of Deceased Civilian Employee. Information collected on the SF 1153 is to be used by the employing agency and, in the event of a disputed claim, by OPM to help determine the claimant’s and others’ rights to the unpaid compensation.

3. Currently, the collection of information occurs in paper form. It is possible that some of the information may be collected electronically in the future, but improved information technology is unlikely to completely reduce the burden since supporting information cannot always be obtained from other sources.

3. The forms are filed individually. Similar information is not available. Duplication is minimal.

3. Information is not collected from small businesses.

3. The collection of this information is necessary to assist agencies and OPM with the distribution of deceased employees’ compensation. If this information is not collected, agencies and OPM will have difficulty or be inefficient in distributing these monies to the proper individuals.

7. This information collection is consistent with the guidelines in 5 CFR 1320.6, except 1320.6(b). A timely response is necessary in order to determine a claimant’s rights.

7. A 60-day notice of the proposed information collection was published in the Federal Resister on October 1, 2014, as required by 5 CFR 1320, giving persons outside the agency an opportunity to comment on the form. No comments were received during the 60-day comment period. A 30-day notice was published in the Federal Register on March 5, 2015. There was a submission extension granted by OMB for the 30-day notice due to a delay in publication within the Federal Register of 10 days from the date of submission by OPM.

7. No payment or gift is made to the respondents

7. This information collection is protected by the Privacy Act of 1974 and OPM regulations (5 CFR 293.201 and 293.202).

7. The 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.

7. Based on our records, approximately 3,000 claims are submitted annually. It takes approximately 15 minutes to compile the information needed to submit a claim. The annual estimated burden is 750 hours.

7. There is no cost to the respondents.

7. The annualized cost to the Federal Government is $30,000. This cost includes employee salary hours devoted to the program and overhead.

7. Between 2004 and 2014, our experience has shown that the number of claims has remained relatively stable, ranging from 3,016 to 3,110.

7. In the event of a disputed claim, OPM reviews the information submitted by the claimant and the agency and renders a decision on whether to grant or deny the claim. The decision is documented in a synopsis which explains the facts of the claim and the justification for the decision. The decision is then placed on OPM’s website, with any identifying information removed.

7. Based on the expense associate with reprinting forms, we request that the expiration date not be printed on the form.

7. There are no exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods

This information collection does not employ statistical methods.