Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System

Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System

OMB: 3206-0162

IC ID: 33635

Information Collection (IC) Details

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Report of Medical Examination of Person Electing Survivor Benefits Under the Civil Service Retirement System
 
No Modified
 
Required to Obtain or Retain Benefits
 
5 CFR 831.613

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction OPM 1530 Report of Medical Examination of Person.... OPM1530_2024_04.pdf www.opm.gov Yes No Fillable Printable

General Government Central Personnel

OPM/Central-1  73 FR 15013

500 0
   
Individuals or Households
 
   0 %

  Approved 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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 750 0 0 0 0 750
Annual IC Cost Burden (Dollars) 6,719 0 0 0 0 6,719

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