Application for Senior Administrative Law Judge

Application for Senior Administrative Law Judge & Geographic Preference Statement for Senior Administrative Law Judge

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0248 can be found here:

Documents and Forms

Document Name Document Type
Form OPM 1655 Application for Senior Administrative Law Judge Form and Instruction
OPM 1655 Application for Senior Administrative Law Judge 4 - OPM Form 1655.pdf Form and Instruction
OPM 1655 Applicationfor Senior Administrative Law Judge 3 - OPM Form 1655 rev.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Application for Senior Administrative Law Judge	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 930.201

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OPM 1655	Applicationfor Senior Administrative Law Judge	3 - OPM Form 1655 rev.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title: OPM Central 6	FR Citation: 60 FR 63084

Number of Respondents: 150	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	Previously Approved
Annual Number of Responses for this IC	150	0	150
Annual IC Time Burden (Hours)	94	0	94
Annual IC Cost Burden (Dollars)	4,611	4,611	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.