Information Collection

Annuitant's Report of Earned Income

IC 33551 under ICR 201912-3206-002 · OMB 3206-0034.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0034 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
RI30-002_2019_01.pdf RI 30-002_2019_Revised	IC Document
RI30-002_2018_01_MarkUp.pdf RI 30-002_2018_MarkUp	IC Document

IC Title:

Annuitant's Report of Earned Income

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR Ch I 844.402 5 CFR Ch I 831.1209 (To search for a specific CFR, visit the Code of Federal Regulations.)

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

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: 21,000

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	21,000	21,000
Annual IC Time Burden (Hours)	12,250	12,250
Annual IC Cost Burden (Dollars)	328,913	328,913

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
RI 30-002_2019_Revised	RI30-002_2019_01.pdf	10/04/2019
RI 30-002_2018_MarkUp	RI30-002_2018_01_MarkUp.pdf	10/04/2019

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