Information Collection

Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....

IC 33658 under ICR 201607-3206-006 · OMB 3206-0174.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0174 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI 20-63 Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....	Form and Instruction
RI 20-63 Survivor Annuity Election for a Spouse RI 20-63 August 2011.pdf	Form and Instruction
RI 20-116 Cover Letter Giving Information About the Cost to Elect RI 20-116 November 2013.pdf	Form and Instruction
RI 20-117 Cover Letter Giving Information About the Cost to Elect RI 20 -117 November 2013.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....

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 831.631 5 CFR 831.632 5 CFR 842.611 5 CFR 842.612 5 CFR 842.613 5 CFR 842.614 5 CFR 842.615

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 20-63	Survivor Annuity Election for a Spouse	RI 20-63 August 2011.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-116	Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity	RI 20-116 November 2013.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-117	Cover Letter Giving Information About the Cost to Elect The Maximum Survivor	RI 20 -117 November 2013.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title: OPM/Central-1

FR Citation: 75 FR 15013

Number of Respondents: 2,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	1,834	1,834
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.