Information Collection

Retirement Booklet Survey

IC 248347 under ICR 202011-3206-008 · OMB 3206-0276.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0276 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RS Booklet Survey Retirement Booklet Survey	Form and Instruction
RS Booklet Survey RS Annuitant Survey 07-06-21.docx	Form and Instruction
Privacy Act Statement 05-14-21.docx Privacy Act Statement	IC Document
Statement A 07-06-21.docx Statement A	IC Document
Supporting Statement B 05-14-21.docx Statement B	IC Document

IC Title:

Retirement Booklet Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR Subpart A 831.101 (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	RS Booklet				Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	833	833
Annual IC Cost Burden (Dollars)	100,000	100,000

Documents for IC

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].