Information Collection

CSRS/FERS Documentation in Support of Disability Retirement Application

IC 33732 under ICR 202203-3206-012 · OMB 3206-0228.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0228 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF 3112 CSRS/FERS Documentation in Support of Disability Retirement Application	Form and Instruction
Form SF 3112 CSRS/FERS Documentation in Support of Disability Retirement Application CSRS/FERS Documentation in Support of Disability Retirement Application	Form and Instruction
Form SF 3112_MarkUp CSRS/FERS Documentation in Support of Disability Retirement Application CSRS/FERS Documentation in Support of Disability Retirement Application	Form and Instruction
SF 3112 CSRS/FERS Documentation in Support of Disability Retirem SF3112_2021_02.pdf	Form and Instruction
SF 3112 CSRS/FERS Documentation in Support of Disability Retirem SF3112_2021_02.pdf	Form and Instruction
SF 3112_MarkUp CSRS/FERS Documentation in Support of Disability Retirem SF3112_2018_02_MarkUp.pdf	Form and Instruction
SF 3112_MarkUp CSRS/FERS Documentation in Support of Disability Retirem SF3112_2018_02_MarkUp.pdf	Form and Instruction
SF3112_2018_02_MarkUp.pdf Mock up	IC Document
SF3112_2018_02_MarkUp.pdf Mock up	IC Document

IC Title:

CSRS/FERS Documentation in Support of Disability Retirement Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 844 Subpart C 5 CFR 831 Subpart L

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	SF 3112			www.opm.gov	Yes	No	Fillable Printable
Form and Instruction	SF 3112_MarkUp			www.opm.gov	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title: OPM/Central-1

FR Citation: 73 FR 15013

Number of Respondents: 13,450

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	Previously Approved
Annual Number of Responses for this IC	13,450	13,450
Annual IC Time Burden (Hours)	12,775	12,775
Annual IC Cost Burden (Dollars)	274,662	274,662

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Mock up		03/23/2021

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

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