Document
OMB SUPPORTING STATEMENT
ICR 202607-3206-007 · OMB 3206-0194 · Object 171245800.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | OMB SUPPORTING STATEMENT |
| Author | MEMOORE |
| 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: 3206-0194, RI 92-22 – Annuity Supplement Earnings Report
A. Justification
1. Explain the circumstances of this collection, why this collection is necessary. and the legal statutes that allow it.
Form RI 92-22 is used to obtain annually the earned income of Federal Employees Retirement System (FERS) annuitants receiving an annuity supplement. Title 5, U. S. Code, Chapter 84, Section 8421 and 5 CFR 842.504 provide for payment of an annuity supplement to non-disability retirees under FERS who meet the eligibility requirements. The annuity supplement is provided to eligible FERS employees who retire before age 62, approximating the portion of a full career Social Security benefit earned while under FERS and ending at age 62 when Social Security benefits become available. Like Social Security benefits, the annuity supplement is subject to an earnings limitation as specified in 5 USC 8421a. An earnings test based on an earnings-exempt amount established each year by the Social Security Administration (SSA) is required to determine the amount of and continued eligibility for the supplement. 5 CFR 842.505(c) states, “Earnings and estimated earnings for each test year will be furnished by retirees in a form prescribed by OPM.”
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.
The information collected using RI 92-22 allows OPM to determine if the earnings from work performed while entitled to the annuity supplement have exceeded the earnings limitation established by SSA. Earnings that exceed the exempt amount reduce the annuity supplement by one dollar for every two dollars the exempt amount is exceeded. However, the reduction never exceeds the amount of the annuity supplement.
The earnings test applies only to the annuity supplement and is not used to reduce the basic FERS annuity. Only those whose annuities exceed the earnings limitation are asked to respond.
3. How are the respondents expected to complete the collection? Can this collection be completed electronically (e.g., through a website or application.
This survey year, the FERS Supplement Earnings Report (RI 92-22) will be available for electronic completion and submission within their Retirement Services Online (RSO) account. A hardcopy version will be mailed to non-RSO users. The form can be completed and mailed to 1900 E ST NW, Washington, DC 20415.
4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.
Each RI 92-22 is prepared for the individual respondent who is asked to certify earnings information for the specified year. Duplication is minimized and respondents who did not earn more than the exempt amount are asked not to respond.
5. Does this collection duplicate any other collection of information? Describe why the agency doesn’t already have this information within their systems.
This information collection is required to determine the correct amount of annuity supplements. Less frequent collections would result in incorrect annuity supplement payments.
6. Describe any impacts on small business. If applicable, describe any methods used to minimize those impacts.
Information is not collected from nor has any impact on small businesses or organizations.
7. 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.
There are no special circumstances involved in the collection of this information.
This information collection is consistent with the guidelines in 5 CFR 1320.8(b)(3).
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 March 9, 2026, a 60 Day Federal Register Notice was published at 91 FR 11348 requesting comments. No comments were received.
9. Are payments or gifts given to the respondent?
No payment or gift is provided to respondents.
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 13,000 forms will be processed annually. The form requires approximately 15 minutes for completion. A burden of 3,250 hours is estimated. The Total Respondent Cost is $106,145.
Form Name
Form Number
No. of Respondents
No. of Responses per Respondent
Average Burden per Response (in hours)
Total Annual Burden (in hours)
Average Hourly Wage Rate
Total Annual Respondent Cost
FERS annuitants receiving an annuity supplement
RI 92-22 (Annuity Supplement Earnings Report)
13,000
1
.25
3,250
$32.66
$106,145
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.
While OPM provides a courtesy reply envelope for the return of the form, there is a postage and mileage cost to return the form to OPM. USPS estimates that the average driving distance between post offices is around 9 miles. The cost for first class postage in 2026 is $.73 totaling a cost of $9,490. Mileage cost in 2026 at a rate of $0.725 totals $84,825.
Therefore, the estimated total non-hourly cost is $94,315.
14. Describe the cost incurred by the Federal Government to complete this collection table.
The annualized cost to the Federal government is $328,386.
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”).
The updates in the hour and cost burden described above are due to the latest statistics provided by government reporting and other resources. OPM therefore considers these updates “adjustments” and not the result of deliberate Federal government action.
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.
The details of this ICR are not published. However, there may occasionally be aggregate data reported, as needed, including in Congressional reporting, budget justifications, or other broad reporting.
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. The results of this collection are not published.
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.