Information Collection

RI 94-7, Death Benefit Payment Rollover Election Form

IC 33723 under ICR 201703-3206-018 · OMB 3206-0218.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0218 can be found here:

2020-10-16 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI 94-7 RI 94-7, Death Benefit Payment Rollover Election Form	Form and Instruction
RI 94-7 Death Benefit Payment Rollover Election RI 94-007 May 2011.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

RI 94-7, Death Benefit Payment Rollover Election Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 26 CFR 1.401(a)(31) 26 CFR 3405(c) 26 CFR 1. 402(c) 26 CFR 1.402(f) (To search for a specific CFR, visit the Code of Federal Regulations.)

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	RI 94-7	Death Benefit Payment Rollover Election	RI 94-007 May 2011.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: 73 FR 15013

Number of Respondents: 3,444

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	3,444	3,444
Annual IC Time Burden (Hours)	3,444	3,444
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.