Information Collection

Court Orders Affecting Retirement Benefits - 5 CFR 838.221, 838.421, and 838.721

IC 33695 under ICR 201704-3206-001 · OMB 3206-0204.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form COARB Denial No Divorce Decree Court Orders Affecting Retirement Benefits - 5 CFR 838.221, 838.421, and 838.721	Form and Instruction
Court Order Regulations.pdf	Other-Regulation
COARB Denial No Divorce Decree Denial No Divorce Decree.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 838.421 5 CFR 838.721 5 CFR 838.221

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
Other-Regulation					No		Printable Only
Form and Instruction	COARB				No		Paper Only

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: 19,000

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	19,000	19,000
Annual IC Time Burden (Hours)	9,500	9,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].