Notice of Change in Student's Status

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form RI 25-15 Notice of Change in Student's Status	Form and Instruction	Modified	Available
Ri 25-15 revised Markup copy.pdf	Supplementary Document	Uploaded 2016-02-23	Available
RI25-015_30DayFRN_Published_2016_02_22.pdf	Supplementary Document	Uploaded 2016-02-23	Available
RI25-015_60DayFRN_Published.pdf	Supplementary Document	Uploaded 2016-02-23	Available
RI 25-15 February 2013 Markup.pdf	Supplementary Document	Uploaded 2013-01-23	Available
OMB Supporting Statement R I 25-15-September 2015.docx	Supporting Statement A	Uploaded 2016-02-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
33560	Notice of Change in Student's Status	Form and Instruction	Modified

ICR Details

OMB Control No: 3206-0042	ICR Reference No: 201602-3206-003
Status: Historical Active	Previous ICR Reference No: 201301-3206-001
Agency/Subagency: OPM	Agency Tracking No:
Title: Notice of Change in Student's Status
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/12/2016
	Date Received in OIRA: 02/23/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved	05/31/2016
Responses	2,500	0	2,500
Time Burden (Hours)	835	0	835
Cost Burden (Dollars)	0	0	0

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Abstract: Since the last OMB review we have updated the zip codes in the address sections on the form and changes the name of the office to which any comments should be sent from Retirement & Benefits to Retirement Publications Team in the Public Burden Statement at the end of the form. Minor non-substantial changes were made and for revised date updated. RI 25-15 is used to collect sufficient information from adult children of deceased Federal employees or annuitants to assure that the child continues to be eligible for payments from OPM.

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Authorizing Statute(s): US Code: 5 USC Chapter 83, Section 8341(a)(4) Name of Law: Civil Service Retirement System
   US Code: 5 USC Chapter 84, Section 8441(4) Name of Law: Federal Employees Retirement System
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 169	09/01/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 34	02/22/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Notice of Change in Student's Status	RI 25-15	Notice of Change in Student’s Status

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,500	2,500	0	0	0	0
Annual Time Burden (Hours)	835	835	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $43,900

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/23/2016

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