Document
Supporting Statement A
ICR 202607-3206-002 · OMB 3206-0128 · Object 171240000.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Supporting Statement A |
| Last Modified By | Writer |
| File Modified | 2026-07-23 |
| File Created | 2026-07-24 |
| Conversion State | complete |
Extracted Text
Supporting Statement for Paperwork Reduction Act Submissions
OMB Control Number: Application for Refund of Retirement Deductions (CSRS)
Current/Former Spouse’s Notification of Application for Refund of Retirement Deductions, 3206-0128
A. Justification
1. Explain the circumstances of this collection, why this collection is necessary. and the legal statutes that allow it.
This Information Collection Request (ICR) consists of two forms: Standard Form 2802, Application for Refund of Retirement Deductions and a subset form Standard Form 2802A, Current/Former Spouse’s Notification of Application for Refund of Retirement Deductions. SF 2802, Application for Refund of Retirement Deductions, is designed to collect sufficient information to permit the Office of Personnel Management (OPM) to comply with the law. SF 2802A is used to inform eligible spouses or former spouses of the application for refund.
Title 5, U. S. Code, Chapter 83, and Section 8342 provide for the payment from the Civil Service Retirement and Disability Fund of lump-sum refunds of retirement deductions and any other monies to the credit of the eligible individual plus any interest provided by law. A former employee who has been separated at the time of filing an application for refund and who is ineligible for an annuity at the time of filing an application for refund is eligible for a refund for the total lump-sum credit to his or her credit in the Retirement Fund.
2. Describe how, by whom, and for what purpose the information is to be used. Except for a new collection, describe how the agency has made use of the information received from the current collection.
5 U.S.C. 8342(a) and (j) provide protection for current and former spouses by requiring the applicant for a refund to notify said persons of the intention to take a refund. The former and current spouse must be notified of the employee’s intent to apply and take a refund of his or her contributions. The spouse is required to sign the form to acknowledge awareness of the application for a refund. If there is a court order for which OPM is not aware of, this gives the former spouse an opportunity to present evidence for us to review. If necessary, a court order to pay a former spouse can prevent payment of the employee’s contributions. The contributions will remain in the Retirement Fund until his/her death and is available to the former spouse in accordance with a court order, if applicable. This action makes it easier in the long term for OPM to advise the former spouse that a benefit is not payable after the death of the employee, and the spousal consent is available to remind the former and/or current spouse of their consent and action taken.
3. How are the respondents expected to complete the collection? Can this collection be completed electronically (e.g., through a website or application.
This form is available on our website in a pdf fillable format at www.opm.gov/forms/standard-forms/ . This form is electronically available to print, complete and mail to: OPM, Retirement Operations Ctr, Attn: Refund Section, PO Box 45, Boyers, PA 16017 - 0045.
4. Does this collection duplicate any other collection of information? Describe why the agency doesn’t already have this information within their systems.
This collection notifies the former and current spouse of the employee’s intent to apply and take a refund of the employee’s contributions. OPM would have records and information to identify the former and current spouse. Therefore, OPM would limit notification so that OPM can properly adjudicate the refund application.
5. Describe any impacts on small business. If applicable, describe any methods used to minimize those impacts.
This information collection request has no impact on small businesses and organizations.
6. What are consequences to the Federal program or policy goals if this collection is not done or the information is collected less frequently? Describe any technical or legal obstacles to reducing burden.
Information is collected as needed to determine eligibility. Without proof of the notification, OPM cannot pay the refund. Court orders in favor of the financial interests of spouses or former spouses can bar refund payments. Less frequent collection would delay or deny benefits provided by law.
7. Do any of the following special circumstances apply?
• requiring respondents to report information to the agency more often than quarterly;
•requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;
•requiring respondents to submit more than an original and two copies of any document;
• requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records, for more than three years;
• in connection with a statistical survey, that is not designed to produce valid and reliable results that can be generalized to the universe of study;
• requiring the use of a statistical data classification that has not been reviewed and approved by OMB;
• that includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or
• requiring respondents to submit proprietary trade secrets, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law.
There are no special circumstances involved in the collection of this information.
8. Cite the Federal Register publication for a request for public comments and address any comments received.
On February 24, 2026, a 60 Day Federal Register Notice was published at 91 FR 8920, requesting comments. No comments were received.
9. Are payments or gifts given to the respondent?
No payment or gift is provided to these respondents, except the refund of monies to their
credit from the Civil Service Retirement and Disability Fund.
10. Describe any assurances of privacy/confidentiality. Cite specific privacy laws, relevant OPM regulations, and SORNs.
This information collection is protected by the Privacy Act of 1974 and OPM regulations
(5 CFR 831.106). The routine uses of disclosure appear in the Federal Register for OPM/Central-1 (87 FR 5874, published February 2, 2022; revised 88 FR 56058 August 17, 2023).
11. Are any questions of a sensitive nature asked, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private? If yes, provide justification. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.
This information collection does not include questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.
12. Describe the hour time burden and the hour cost burden on the respondent needed to complete this collection. Please specify hourly salary for your respondent audience by referencing Bureau of Labor Statistics Occupational Employment and Wage Estimates
or other alternative wage site, when applicable.
Approximately 3,741 SF 2802s and 3,389 SF 2802As are processed annually. SF 2802 requires approximately one hour for completion with an annual burden of 3,741 hours. SF 2802A requires approximately 15 minutes for completion for with an annual burden of 847 hours. The total burden for these forms is 4,588 hours.
The total Annual Respondent Cost is $149,844.
13. Describe the non-hourly monetary burden to respondents needed to complete this
collection. This is defined as out-of-pocket costs such as application fees for the collection, document fees (birth/death certificates, school transcripts), mailing costs (printing, postage, and/or mileage), or anything else respondents may need to pay to complete and/or implement the collection.
There is no general cost associated with this information collection.
14. Describe the cost incurred by the Federal Government to complete this collection table.
The annualized cost to the Federal government is $20,360.
15. Explain any changes/adjustments to this collection since the previous submission, if
applicable. Describe whether these changes impact the hour or cost burden. If yes, describe
if the impact is the result of deliberate Federal government action (“program change”) or
something else (“adjustment”).
A small number of formatting and language changes have been made to the form since it was last submitted for renewal, which are listed below. However, there is no change in the hour or cost burden that is not based on updates on economic data. Therefore, any changes noted would be categorized as “adjustments.”
• Page One
◦ Under the OMB Control Number, the following language was added: See the attached sheets for instructions and information concerning your application for refund of retirement deductions and a Privacy Act Statement.
◦ The rows on the page were reduced from five to four.
◦ Questions 8 – 13 have been consolidated and reformatted for easier understanding.
• Page Two
◦ In the Applicant Certification section, the space has been rearranged for spacing and increased chance of response.
• Page Three
◦ Deleted text section "Information About Former Spouses" and added it to Item 13 on page 1.
• Page Four and Eight
◦ The Privacy Act and Public Burden Statements have been updated per feedback from the Privacy Office and OMB.
16. Specify if the data gathered by this collection will be published. This could include
Congressional reporting, using respondent numbers in budget justification, or other broad
reporting.
No information collected from this form will be published.
17. If applicable, explain the reason(s) for seeking approval to not display the OMB expiration
date.
We seek approval to not display the OMB clearance expiration date on the forms and to communicate version changes to the public via the revision date. OPM is modifying the Paperwork Reduction Act notice to ensure respondents can verify the validity of the OMB control number and collection.
18. Explain each exception to the topics of the certification statement identified in
“Certification for Paperwork Reduction Act Submissions.”
There are no exceptions to the certification statement.