CSRS/FERS Documentation in Support of Disability Retirement Application

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form SF 3112 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 www.opm.gov Form and Instruction
SF 3112 CSRS/FERS Documentation in Support of Disability Retirem SF3112_2021_02.pdf www.opm.gov Form and Instruction
SF 3112_MarkUp CSRS/FERS Documentation in Support of Disability Retirem SF3112_2018_02_MarkUp.pdf www.opm.gov Form and Instruction
SF 3112_MarkUp CSRS/FERS Documentation in Support of Disability Retirem SF3112_2018_02_MarkUp.pdf www.opm.gov Form and Instruction
SF3112_2018_02_MarkUp.pdf Mock up IC Document
SF3112_2018_02_MarkUp.pdf Mock up IC Document

Information Collection (IC) Details

View Information Collection (IC)

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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SF 3112	CSRS/FERS Documentation in Support of Disability Retirement Application	SF3112_2021_02.pdf	www.opm.gov	Yes	No	Fillable Printable
Form and Instruction	SF 3112_MarkUp	CSRS/FERS Documentation in Support of Disability Retirement Application	SF3112_2018_02_MarkUp.pdf	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 %

	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

Title	Document	Date Uploaded
Mock up	SF3112_2018_02_MarkUp.pdf	03/23/2021

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