CSRS/FERS Documentation in Support of Disability Retirement Application

OMB 3206-0228

SF 3112 collects information from applicants for disability retirement so that OPM can determine whether to approve a disability retirement. The applicant will only complete Standard Forms 3112A and 3112C. Standard Forms 3112B, 3112D and 3112E will be completed by the immediate supervisor and the employing agency of the applicant.

The latest form for CSRS/FERS Documentation in Support of Disability Retirement Application expires 2021-02-28 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form SF 3112 CSRS/FERS Documentation in Support of Disability Retirement Application Form and Instruction
OMB_Justification_SF3112_2022_03_08.docx Justification for No Material/Nonsubstantive Change
2021-03964.pdf Supplementary Document
2020-11734.pdf Supplementary Document
SF3112_2018_02_MarkUp.pdf Supplementary Document
SF3112_2021_02_MarkUp.pdf Supplementary Document
ARS PIA Final 12212017signed.pdf Supplementary Document
SF3112_Regs.pdf Supplementary Document
SF3112_OMBSupportingStmt_2021_02_18.docx Supporting Statement A
CSRS/FERS Documentation in Support of Disability Retirement Application Form and Instruction

All Historical Document Collections

202203-3206-012 Approved without change	No material or nonsubstantive change to a currently approved collection	2022-03-08
202102-3206-004 Approved without change	Revision of a currently approved collection	2021-02-26
201712-3206-009 Approved with change	Revision of a currently approved collection	2017-12-29
201602-3206-001 Approved with change	Extension without change of a currently approved collection	2016-02-19
201303-3206-005 Approved without change	Extension without change of a currently approved collection	2013-03-28
201004-3206-011 Approved without change	Revision of a currently approved collection	2010-04-26
200704-3206-003 Approved without change	Extension without change of a currently approved collection	2007-04-24
200402-3206-002 Approved without change	Revision of a currently approved collection	2004-02-23
200008-3206-005 Approved without change	Reinstatement without change of a previously approved collection	2000-08-18
199612-3206-004 Approved without change	Reinstatement with change of a previously approved collection	1996-12-18
199509-3206-001 Approved without change	New collection (Request for a new OMB Control Number)	1995-09-01