Information Collection

SF 3102, Designation of Beneficiary (FERS)

IC 33655 under ICR 202207-3206-003 · OMB 3206-0173.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF 3102 SF 3102, Designation of Beneficiary (FERS)	Form and Instruction
SF 3102 CSRS and FERS Designation of Beneficiary SF3102_2022_10_MarkUp.pdf	Form and Instruction
SF 3102 CSRS and FERS Designation of Beneficiary SF3102_2022_10_MarkUp.pdf	Form and Instruction
SF 3102 CSRS and FERS Designation of Beneficiary SF3102_2021_08_MarkUp.pdf	Form and Instruction
SF 3102 CSRS and FERS Designation of Beneficiary SF3102_2021_08_MarkUp.pdf	Form and Instruction

IC Title:

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 843.203 - 843.205

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 3102	CSRS and FERS Designation of Beneficiary	SF3102_2022_10_MarkUp.pdf		Yes	No	Fillable Printable
Form and Instruction	SF 3102	CSRS and FERS Designation of Beneficiary	SF3102_2021_08_MarkUp.pdf		Yes	No	Fillable Printable

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: 3,888

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	3,888	3,888
Annual IC Time Burden (Hours)	972	972
Annual IC Cost Burden (Dollars)	39,376	39,376

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.