RI 92-22, Annuity Supplement Earnings Report

ICR 201704-3206-002

OMB: 3206-0194

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2017-04-06
Justification for No Material/Nonsubstantive Change
2017-04-06
IC Document Collections
IC ID
Document
Title
Status
33678 Modified
ICR Details
3206-0194 201704-3206-002
Historical Active 201603-3206-007
OPM
RI 92-22, Annuity Supplement Earnings Report
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 09/22/2017
Retrieve Notice of Action (NOA) 05/01/2017
  Inventory as of this Action Requested Previously Approved
12/31/2017 12/31/2017 12/31/2017
13,000 0 13,000
3,250 0 3,250
0 0 0

RI 92-22, Annuity Supplement Earnings Report, is used each year to obtain the earned income of Federal Employees Retirement System (FERS) annuitants receiving an annuity supplement. The annuity supplement is paid to eligible FERS annuitants who are not retired on disability and are not yet age 62. The supplement approximates the portion of a full career Social Security benefit earned while under FERS and ends at age 62. Like Social Security benefits, the annuity supplement is subject to an earnings limitation. Minor editorial changes to the year and dollar amounts.

US Code: 5 USC Chapter 84, Section 8421 Name of Law: FERS, Annuity Supplement
  
None

Not associated with rulemaking

  80 FR 48125 08/11/2015
81 FR 15579 03/23/2016
No

1
IC Title Form No. Form Name
Annuity Supplement Earnings Report RI 92-22 Annuity Supplement Earnings Report

  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 13,000 13,000 0 0 0 0
Annual Time Burden (Hours) 3,250 3,250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$45,550
No
    Yes
    Yes
No
No
No
Uncollected
Charles Conyers 202 606-0125 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/01/2017


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