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RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit
RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit
OMB: 3206-0254
IC ID: 194854
OMB.report
OPM
OMB 3206-0254
ICR 202211-3206-004
IC 194854
( )
Documents and Forms
Document Name
Document Type
Form RI 20-123
RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit
Form and Instruction
RI 20-123 Request for Case Review for Enhanced Disability Annuity
RI 20-123_2020_01.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
RI 20-123
Request for Case Review for Enhanced Disability Annuity Benefit
RI 20-123_2020_01.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:
100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
100
0
0
0
0
100
Annual IC Time Burden (Hours)
8
0
0
0
0
8
Annual IC Cost Burden (Dollars)
225
0
0
225
0
0
Documents for IC
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.