Information Collection

RI 94-7, Death Benefit Payment Rollover Election Form

IC 33723 under ICR 202010-3206-011 · OMB 3206-0218.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI 94-7 RI 94-7, Death Benefit Payment Rollover Election Form	Form and Instruction
RI 94-7 Death Benefit Payment Rollover Election_Revised RI94-007_2020_07_Revised.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

RI 94-7, Death Benefit Payment Rollover Election Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 26 CFR 3405(c) 26 CFR 1.401(a)(31) 26 CFR 1. 402(c) 26 CFR 1.402(f) (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
Form and Instruction	RI 94-7	Death Benefit Payment Rollover Election_Revised	RI94-007_2020_07_Revised.pdf		Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

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: 3,444

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	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,444	0	0	3,444
Annual IC Time Burden (Hours)	3,444	0	0	3,444
Annual IC Cost Burden (Dollars)	0	-92,558	92,558	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.