Information Collection

FED VIP (BENFEDS.com)

IC 233779 under ICR 202510-3206-001 · OMB 3206-0272.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FED VIP (BENFEDS.com)	Form and Instruction
FEDVIP Enrollment FED VIP (BENFEDS.com)	Form and Instruction
Federal Employees Dental and Vision Insurance Program En FEDVIP Screenshots.docx BENEFEDS.GOV	Form and Instruction
FEDVIP Enrollment FEDVIP Screenshots Final.docx benefeds.gov	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 Chapter 89B 5 CFR Chapter 89 A (To search for a specific CFR, visit the Code of Federal Regulations.)

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	N/A			benefeds.gov	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title: OPM/Central-1, Civil Service Retirement and Insurance Records

FR Citation: 82 FR 32191

Number of Respondents: 502,347

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	502,347	170,043	332,304
Annual IC Time Burden (Hours)	58,858	14,551	44,307
Annual IC Cost Burden (Dollars)	2,088,759	1,929,771	158,988

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.

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