Designation of Beneficiary (CSRS and FERS)

OMB 3206-0173

OMB 3206-0173

This form is used by employees and annuitants covered under the Federal Employees Retirement System to designate a beneficiary to receive any lump sum due in the event of his/her death. The form was revised to update the Privacy Act Statement.

The latest form for Designation of Beneficiary (CSRS and FERS) expires 2021-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form and Instruction
Justification for No Material/Nonsubstantive Change
Justification for No Material/Nonsubstantive Change
Supplementary Document
Supplementary Document
Supplementary Document
Supplementary Document
Supporting Statement A
All Historical Document Collections
Approved without change
No material or nonsubstantive change to a currently approved collection 2022-07-14
Approved without change
No material or nonsubstantive change to a currently approved collection 2022-03-07
Approved without change
Revision of a currently approved collection 2021-06-30
Approved with change
Revision of a currently approved collection 2018-02-22
Approved without change
Revision of a currently approved collection 2015-01-26
Approved without change
Revision of a currently approved collection 2011-12-12
Approved without change
Extension without change of a currently approved collection 2009-03-25
Approved with change
Revision of a currently approved collection 2005-10-05
Approved with change
Revision of a currently approved collection 2002-06-14
Approved without change
Reinstatement with change of a previously approved collection 1999-06-09
Approved without change
Reinstatement without change of a previously approved collection 1996-04-04
Approved without change
Revision of a currently approved collection 1993-01-07
Approved without change
Reinstatement with change of a previously approved collection 1990-12-12
Approved without change
Extension without change of a currently approved collection 1987-06-23
Approved without change
New collection (Request for a new OMB Control Number) 1987-04-06

© 2024 OMB.report | Privacy Policy