Information Collection

Notices of Amount Due Because of Annuity Overpayment

IC 33642 under ICR 202205-3206-001 · OMB 3206-0167.

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_2021_08_MarkUp.pdf	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2021_08_MarkUp.pdf	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2022_07_Revised.pdf	Form and Instruction
RI 34-1 Financial Resources Questionnaire RI34-001_2022_07_Revised.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because Of Annuity Overpayment RI34-003_2021_08_MarkUp.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because Of Annuity Overpayment RI34-003_2021_08_MarkUp.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because Of Annuity Overpayment RI34-003_2022_07_Revised.pdf	Form and Instruction
RI 34-3 Notice of Amount Due Because Of Annuity Overpayment RI34-003_2022_07_Revised.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire - Federal Employees’ G RI34-017_2021_08_MarkUp.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire - Federal Employees’ G RI34-017_2021_08_MarkUp.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire - Federal Employees’ G RI34-017_2022_07_Revised.pdf	Form and Instruction
RI 34-17 Financial Resources Questionnaire - Federal Employees’ G RI34-017_2022_07_Revised.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire - Federal Employees He RI34-018_2021_08_MarkUp.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire - Federal Employees He RI34-018_2021_08_MarkUp.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire - Federal Employees’ G RI34-018_2022_07_Revised.pdf	Form and Instruction
RI 34-18 Financial Resources Questionnaire - Federal Employees’ G RI34-018_2022_07_Revised.pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI34-019_2021_08_MarkUp.pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI34-019_2021_08_MarkUp.pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI34-019_2022_07_Revised.pdf	Form and Instruction
RI 34-19 Notice of Amount Due Because of FEGLI Premium Underpayme RI34-019_2022_07_Revised.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI34-020_2021_08_MarkUp.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI34-020_2021_08_MarkUp.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI34-020_2022_07_Revised.pdf	Form and Instruction
RI 34-20 Notice of Amount Due Because of FEHB Premium Underpaymen RI34-020_2022_07_Revised.pdf	Form and Instruction
JUSTIFICATION FOR CHANGES TO RI 34-1 (1).docx Justification	IC Document
JUSTIFICATION FOR CHANGES TO RI 34-1 (1).docx Justification	IC Document

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 845 5 CFR 831 Subpart M and N

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_2021_08_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-1	Financial Resources Questionnaire	RI34-001_2022_07_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-3	Notice of Amount Due Because Of Annuity Overpayment	RI34-003_2021_08_MarkUp.pdf	Yes	No	Paper Only
Form and Instruction	RI 34-3	Notice of Amount Due Because Of Annuity Overpayment	RI34-003_2022_07_Revised.pdf	Yes	No	Paper Only
Form and Instruction	RI 34-17	Financial Resources Questionnaire - Federal Employeesâ Group Life Insurance Premiums Underpaid	RI34-017_2021_08_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-17	Financial Resources Questionnaire - Federal Employeesâ Group Life Insurance Premiums Underpaid	RI34-017_2022_07_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-18	Financial Resources Questionnaire - Federal Employees Health Benefits Premiums Underpaid	RI34-018_2021_08_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-18	Financial Resources Questionnaire - Federal Employeesâ Group Life Insurance Premiums Underpaid	RI34-018_2022_07_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 34-19	Notice of Amount Due Because of FEGLI Premium Underpayment	RI34-019_2021_08_MarkUp.pdf	No		Paper Only
Form and Instruction	RI 34-19	Notice of Amount Due Because of FEGLI Premium Underpayment	RI34-019_2022_07_Revised.pdf	No		Paper Only
Form and Instruction	RI 34-20	Notice of Amount Due Because of FEHB Premium Underpayment	RI34-020_2021_08_MarkUp.pdf	No		Paper Only
Form and Instruction	RI 34-20	Notice of Amount Due Because of FEHB Premium Underpayment	RI34-020_2022_07_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	Previously Approved
Annual Number of Responses for this IC	2,361	2,361
Annual IC Time Burden (Hours)	2,361	2,361
Annual IC Cost Burden (Dollars)	63,452	63,452

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	JUSTIFICATION FOR CHANGES TO RI 34-1 (1).docx	05/20/2022

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