OMB SUPPORTING STATEMENT
SF 3106 Application for Refund of Retirement Deductions
SF 3106A Current/Former Spouse's Notification of Application for Refund of Retirement Deductions
Justification
5 USC, Chapter 84 provides for the payment from the Federal Employees Retirement System of lump sum refunds of retirement deductions and any other monies to the credit of the eligible individual, plus any interest provided by law.
5 USC, Chapter 84 also provides for the notification of any current spouse and any former spouse of the application for refund of retirement deductions prior to payment of the lump sum credit.
The information collected permits OPM to determine whether the respondent is eligible to receive the refund, whether to withhold for Federal income tax and to meet requirements of the law. If this information is not collected, OPM cannot pay the refund. There are editorial changes to the Public Burden Statement. The Privacy Act Statement has been revised due to a general systematic review by our Chief Privacy Officer.
The information collected can only be obtained from the respondents. New methods of information technology would do little to reduce the burden on the respondents; they must sign the application attesting to its truth, under penalty of law, to the best of their knowledge. The form is available in PDF fillable format on our website at www.opm.gov/forms.
These applications are filed individually each time a former employee requests a refund of retirement contributions. This request is not recorded elsewhere. Duplication is minimized as up-to-date, similar information is not available.
This information collection request has no impact on small businesses and organizations.
The collection of this information is performed as needed to determine eligibility. Less frequent collection is not applicable. This information collection is consistent with the guidelines in 5 CFR 1320.6.
There are no special circumstances involved in the collection of this information.
On April 13, 2017, a 60 Day Federal Register Notice was published at 82 FR 17893. There were no comments received.
No gifts or payments of any kind have been provided to any individuals who are connected to this collection.
This information collection is protected by the Privacy Act of 1974 and OPM regulations (5 CFR 831.106). The routine uses of disclosure appear in the Federal Register for OPM/Central-1 (73 FR 15013, et seq., March 20, 2008, effective April 21, 2008).
This information collection does not include questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.
12. A total of approximately 4,534 hours are used to complete the SF 3106 and SF 3106A annually.
Approximately 8,000 SF 3106,
Application for
Refund of Retirement Deductions,
will be processed annually. The SF 3106 takes 30 minutes to complete
for a total of 4,000 hours annually.
Approximately 6,400
SF 3106A, Current/Former
Spouse’s Notification of Application for Refund of Retirement
Deductions, will be
processed annually. The SF 3106A takes 5 minutes to complete for a
total of 534 hours annually.
Form Name |
Form Number |
No. of Respondents |
No. of Responses per Respondent |
Average Burden per Response (in hours) |
Total Annual Burden (in hours) |
Average Hourly Wage Rate |
Total Annual Respondent Cost |
Application for Refund of Retirement Deductions |
SF 3106 |
8,000 |
1 |
30 minutes |
4,000 |
$0 |
$0 |
Current/Former Spouse’s Notification of Application for Refund of Retirement Deductions |
SF 3106A |
6,400 |
1 |
5 minutes |
534 |
$0 |
$0 |
There is no cost to the respondents.
13. There is no change in the respondent burden.
14. The annualized cost to the
Federal government for both forms is $136,512. This cost includes
employee salary hours devoted to this program, forms and
overhead.
15. N/A
16. No information collected from the form will be published.
17.
The Retirement Services program office is the lone processor of the
data collected on
these ICRs from approximately 2.8 million
customers. The substance of each information collection does not
substantively change at each OMB renewal cycle, but according to
changes in law and regulation. These forms are printed and published
(internet, intranet and on-board systems) through various agencies
for distribution to and implementation by Government customers.
Pursuant to title 5 CFR 1320.8(b)(1), it would not be appropriate to
display the OMB clearance expiration date where the form will not be
revised for the foreseeable future (e.g., because it is used to
collect applicant, annuitant, or beneficiary information required by
long-standing statutory provisions), where use of the paper form is
prevalent, and where, accordingly, it will be expensive and
burdensome to restock the paper forms inventory with a new version.
Last year, under current practice, Retirement Services printed
approximately 2 million documents subject to OMB clearance at a cost
of approximately $85,000. Our costs would rise substantially if
additional revision cycles are added. Lastly, by adding the OMB
clearance expiration date to the existing format, the end users of
OPM’s ICRs may erroneously assume that the expiration date
affects the validity of the information collection when it is the OMB
clearance expiration date and not reflective of the substance. This
may lead to additional submissions by customers, possible litigation
and increasing pressures on our Operations workloads. Therefore, we
seek approval to not display the OMB clearance expiration date on the
forms and to communicate version changes to the public via the
revision date.
18. There are no exceptions to the certification statement.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | OMB SUPPORTING STATEMENT |
| Author | MEMOORE |
| File Modified | 0000-00-00 |
| File Created | 2021-01-21 |