Information Collection

The Federal Annuitant Benefits Survey (FABS)

IC 218762 under ICR 201510-3206-007 · OMB 3206-0267.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 001 The Federal Annuitant Benefits Survey (FABS)	Form and Instruction
001 Federal Annuitant Benefits Survey FABS_Final.pdf	Form and Instruction
FABS Supporting Statement A.doc FABS Supporting Documents	IC Document
Published 60 Day Notice.pdf 60 Day Notice	IC Document
Signed 30 Day Notice.pdf 30 Day Notice	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	001	Federal Annuitant Benefits Survey	FABS_Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 720

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	720	720
Annual IC Time Burden (Hours)	240	240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FABS Supporting Documents	FABS Supporting Statement A.doc	10/28/2015
60 Day Notice	Published 60 Day Notice.pdf	10/28/2015
30 Day Notice	Signed 30 Day Notice.pdf	10/28/2015

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