Information Collection

Notices of Amount Due Because of Annuity Overpayment

IC 33642 under ICR 202003-3206-001 · OMB 3206-0167.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0167 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI 34-1 Notices of Amount Due Because of Annuity Overpayment	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2020_03_Revised.pdf	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2018_07_MarkUp.pdf	Form and Instruction
JUSTIFICATION FOR CHANGES TO RI 34-1.docx Justification	IC Document

IC Title:

Notices of Amount Due Because of Annuity Overpayment

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 845 5 CFR 831 Subpart M and N

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
Form and Instruction	RI 34-1	Financial Resources Questionnaire	RI34-001_2020_03_Revised.pdf		Yes	No	Fillable Printable
Form and Instruction	RI 34-1	Financial Resources Questionnaire	RI34-001_2018_07_MarkUp.pdf		Yes	No	Fillable Printable

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: 2,361

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	2,361	2,361
Annual IC Time Burden (Hours)	2,361	2,361
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	JUSTIFICATION FOR CHANGES TO RI 34-1.docx	03/23/2020

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