Information Collection

Claim for Unpaid Compensation of Deceased Civilian Employee

IC 231624 under ICR 202207-3206-002 · OMB 3206-0234.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF 1153 Claim for Unpaid Compensation of Deceased Civilian Employee	Form and Instruction
SF 1153 Claim for Unpaid Compensation of Deceased Civilian Emplo Form SF1153_3206-0234.pdf	Form and Instruction
SF 1153 Claim for Unpaid Compensation of Deceased Civilian Emplo Form SF1153_3206-0234.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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 1153	Claim for Unpaid Compensation of Deceased Civilian Employee	Form SF1153_3206-0234.pdf		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title: OPM/GOVT-1, General Personnel Records

FR Citation: 71 FR 35542

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	3,000	0	3,000
Annual IC Time Burden (Hours)	750	0	750
Annual IC Cost Burden (Dollars)	30,000	30,000	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.