Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)

SF 2823, Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0136 can be found here:

Documents and Forms

Document Name Document Type
Form SF 2823 Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI) Form and Instruction
SF 2823 Designation of Beneficiary, Federal Employees' Group Lif SF2823_2020_07_Revised.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 870.802 5 CFR 870.909

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SF 2823	Designation of Beneficiary, Federal Employees' Group Life Insurance Program_Revised	SF2823_2020_07_Revised.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: 48,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	48,000	0	0	48,000
Annual IC Time Burden (Hours)	12,000	0	0	12,000
Annual IC Cost Burden (Dollars)	0	-2,685	2,685	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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