OMB SUPPORTING STATEMENT
SF 3102, Designation of Beneficiary – (FERS)
Justification
The Federal Employees Retirement System Act of 1986 (PL 99-335), provides that a Federal employee or an annuitant may designate a beneficiary to receive any lump sum payment due from the Federal Employees Retirement System (FERS) in the event of death. SF 3102, Designation of Beneficiary (FERS), is the document which is used to establish the designation.
This
information is used by the Office of Personnel Management, Federal
Employees Retirement System, in determining the proper payee in the
event of death. If SF 3102 is not on file, the lump sum is paid
according to the order of precedence (5 USC 8424(d)) shown in the
instructions on the form.
There are editorial changes to
the Public Burden Statement (PBS). The Privacy Act Statement has
been revised due to a general systematic review by our Chief Privacy
Officer.
Use of improved information technology to reduce the burden is not practical. The information collection is voluntary and must be made in writing. However, this form is available in a PDF fillable format on our website and meets our GPEA requirements.
All designations are filed individually for FERS. Designations of Beneficiary for other systems cannot be used for FERS. Even though the designations may be similar for each system, they all require designations specifically for that system.
This information collection request has no impact on small businesses and organizations.
This information collection cannot be made less frequently because it is filed at the employee’s or annuitant’s option. 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 17890 requesting comment. No comments were received.
No gift or payment is awarded respondents based on return of this form.
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.
Approximately 3,888 forms will be processed annually. The form
requires approximately
15 minutes each to complete. The
annual burden of 972 hours is estimated.
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 |
Designation of Beneficiary (FERS) |
SF 3102 |
3,888 |
1 |
15 minutes |
972 |
$0 |
$0 |
The cost to the respondent is minimal.
13. There is no change in the respondent burden.
14. Annualized cost to the Federal Government is approximately
$15,124.32. This cost is
derived from employee salaries,
staff hours required to process the forms and the cost of
printing, storing and shipping forms.
15. N/A
16. No information collected from this 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 |