No
material or nonsubstantive change to a currently approved
collection
No
Regular
03/07/2022
Requested
Previously Approved
10/31/2024
10/31/2024
3,888
3,888
972
972
39,376
39,376
This form is used by employees and
annuitants covered under the Civil Service Retirement System and
the Federal Employees Retirement System to designate a beneficiary
to receive any lump sum due in the event of his/her death.
US Code:
5 USC
8424 Name of Law: Lump-sum Benefits; Designation of
Beneficiary; Order of Precedence
Charles Conyers 202 606-0125
charles.conyers@opm.gov
No
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.