Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements

Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlements

Documents and Forms

Document Name Document Type
Form CA-1032 Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements Form and Instruction
CA-1032 Request for Information on Earnings, Dual Benefits, Depe Request for Information on Earnings Dual Benefits Dependents and Third Party Settlement (CA-1032) expiration 11.30.2023.docx www.ecomp.dol.gov Form and Instruction
CA-1032 Request for Information on Earnings, Dual Benefits, Depe Request for Information on Earnings Dual Benefits Dependents and Third Party Settlement (CA-1032) expiration 11.30.2023.docx www.ecomp.dol.gov Form and Instruction

Information Collection (IC) Details

IC Title:	Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 10.528

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CA-1032	Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlement	Request for Information on Earnings Dual Benefits Dependents and Third Party Settlement (CA-1032) expiration 11.30.2023.docx	https://www.ecomp.dol.gov	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/GOVT-1	FR Citation: 81 FR 47418

Number of Respondents: 33,372	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 31 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	33,372	-3,684	37,056
Annual IC Time Burden (Hours)	11,013	-1,215	12,228
Annual IC Cost Burden (Dollars)	15,198	168	15,030

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.