Information Collection

Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity

IC 33603 under ICR 202101-3206-007 · OMB 3206-0138.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0138 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI 30-9 Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity	Form and Instruction
RI 30-9 Reinstatement of Disability Annuity Previously Terminate RI30-009_2021_01_MarkUp.pdf www.opm.gov	Form and Instruction
RI 30-9 Reinstatement of Disability Annuity Previously Terminate RI30-009_2021_01_MarkUp.pdf www.opm.gov	Form and Instruction
RI 30-9 Reinstatement of Disability Annuity Previously Terminate RI30-009_2018_02_MarkUp.pdf www.opm.gov	Form and Instruction
RI 30-9 Reinstatement of Disability Annuity Previously Terminate RI30-009_2018_02_MarkUp.pdf www.opm.gov	Form and Instruction

IC Title:

Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity

Agency IC Tracking Number:

RI 30-9

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 844.404 5 CFR 831.1211

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 30-9	Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity	RI30-009_2021_01_MarkUp.pdf	www.opm.gov	Yes	No	Printable Only
Form and Instruction	RI 30-9	Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity	RI30-009_2018_02_MarkUp.pdf	www.opm.gov	Yes	No	Printable Only

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: 200

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	Previously Approved
Annual Number of Responses for this IC	200	0	200
Annual IC Time Burden (Hours)	200	0	200
Annual IC Cost Burden (Dollars)	5,375	5,375	0

Documents for IC

table that charts IC Documents
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.