Information Collection

Request to Disability Annuitant for Information on Physical Condition and Employment

IC 33615 under ICR 202607-3206-005 · OMB 3206-0143.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RI30-01 Request to Disability Annuitant for Information on Physical Condition and Employment Request to Disability Annuitant for Information on Physical Condition and Employment	Form and Instruction
RI30-01 Request to Disability Annuitant for Information on Physi RI30-001_2026.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

RI 30-1

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 844.303 through 844.304 5 CFR 844.401 through 844.403 5 CFR 831.1206 through 831.1211

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	RI30-01			opm.gov	No		Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title: OPM/Central-1

FR Citation: 75 FR 15013

Number of Respondents: 8,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8,000	0	8,000
Annual IC Time Burden (Hours)	8,000	0	8,000
Annual IC Cost Burden (Dollars)	261,280	46,280	215,000

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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