Information Collection

Notices of Amount Due Because of Annuity Overpayment

IC 33642 under ICR 202108-3206-005 · OMB 3206-0167.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0167 can be found here:

2022-05-20 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI 34-1 Notices of Amount Due Because of Annuity Overpayment	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2020_03_MarkUp.pdf	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2020_03_MarkUp.pdf	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2021_08_Revised.pdf	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2021_08_Revised.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because Of Annuity Overpayment RI 34-003_2018_06_MarkUp.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because Of Annuity Overpayment RI 34-003_2018_06_MarkUp.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because Of Annuity Overpayment RI 34-003_2021_08_Revised.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because Of Annuity Overpayment RI 34-003_2021_08_Revised.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire - Federal Employees’ G RI 34-017_2018_06_MarkUp.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire - Federal Employees’ G RI 34-017_2018_06_MarkUp.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire - Federal Employees’ G RI 34-017_2021_08_Revised.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire - Federal Employees’ G RI 34-017_2021_08_Revised.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire - Federal Employees He RI 34-018_2018_06_MarkUp.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire - Federal Employees He RI 34-018_2018_06_MarkUp.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire - Federal Employees’ G RI 34-018_2021_08_Revised.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire - Federal Employees’ G RI 34-018_2021_08_Revised.pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI 34-019_2018_06_MarkUp.pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI 34-019_2018_06_MarkUp.pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI 34-019_2021_08_Revised.pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI 34-019_2021_08_Revised.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI 34-020_2018_06_MarkUp.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI 34-020_2018_06_MarkUp.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI 34-020_2021_08_Revised.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI 34-020_2021_08_Revised.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Notices of Amount Due Because of Annuity Overpayment

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 831 Subpart M and N 5 CFR 845

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 34-1	Financial Resources Questionnaire	RI34-001_2020_03_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-1	Financial Resources Questionnaire	RI34-001_2021_08_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-3	Notice of Amount Due Because Of Annuity Overpayment	RI 34-003_2018_06_MarkUp.pdf	Yes	No	Paper Only
Form and Instruction	RI 34-3	Notice of Amount Due Because Of Annuity Overpayment	RI 34-003_2021_08_Revised.pdf	Yes	No	Paper Only
Form and Instruction	RI 34-17	Financial Resources Questionnaire - Federal Employeesâ Group Life Insurance Premiums Underpaid	RI 34-017_2018_06_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-17	Financial Resources Questionnaire - Federal Employeesâ Group Life Insurance Premiums Underpaid	RI 34-017_2021_08_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-18	Financial Resources Questionnaire - Federal Employees Health Benefits Premiums Underpaid	RI 34-018_2018_06_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-18	Financial Resources Questionnaire - Federal Employeesâ Group Life Insurance Premiums Underpaid	RI 34-018_2021_08_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-19	Notice of Amount Due Because of FEGLI Premium Underpayment	RI 34-019_2018_06_MarkUp.pdf	No		Paper Only
Form and Instruction	RI 34-19	Notice of Amount Due Because of FEGLI Premium Underpayment	RI 34-019_2021_08_Revised.pdf	No		Paper Only
Form and Instruction	RI 34-20	Notice of Amount Due Because of FEHB Premium Underpayment	RI 34-020_2018_06_MarkUp.pdf	No		Paper Only
Form and Instruction	RI 34-20	Notice of Amount Due Because of FEHB Premium Underpayment	RI 34-020_2021_08_Revised.pdf	No		Paper Only

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: 2,361

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	2,361	0	0	2,361
Annual IC Time Burden (Hours)	2,361	0	0	2,361
Annual IC Cost Burden (Dollars)	63,452	1	63,451	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.