Application for Refund of Retirement Deductions (CSRS) Current/Former Spouse's Notification of Application for Refund

ICR 201712-3206-016

OMB: 3206-0128

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2017-12-29
Supplementary Document
2017-12-29
Supplementary Document
2017-12-29
Supplementary Document
2017-12-29
Supplementary Document
2017-12-29
Supporting Statement A
2018-01-09
ICR Details
3206-0128 201712-3206-016
Active 201607-3206-004
OPM SF 2802/SF 2802A
Application for Refund of Retirement Deductions (CSRS) Current/Former Spouse's Notification of Application for Refund
Revision of a currently approved collection   No
Regular
Approved with change 01/30/2018
Retrieve Notice of Action (NOA) 12/29/2017
This collection is approved based on the revised materials provided by the Agency.
  Inventory as of this Action Requested Previously Approved
01/31/2021 36 Months From Approved 01/31/2018
7,130 0 7,130
4,588 0 4,588
0 0 0

SF 2802 is used to support the payment of monies from the Retirement Fund. It identifies that applicant for refund. SF 2802A is used to comply with the legal requirement that any spouse of former spouse of the applicant has been notified that the former employee is applying for a refund.

US Code: 5 USC Chapt. 83, Sect. 8342 Name of Law: Lump-sum benefits; designation of beneficiary;
  
None

Not associated with rulemaking

  82 FR 17897 04/13/2017
82 FR 59668 12/15/2017
No

  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 7,130 7,130 0 0 0 0
Annual Time Burden (Hours) 4,588 4,588 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$20,360
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.
12/29/2017


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