OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Life Insurance Election

OMB 3206-0230 ยท OPM.

OMB 3206-0230

Standard Form 2817, Life Insurance Election, is used by Federal employees and assignees (those who have acquired control of an employee/annuitant's coverage through an assignment or ''transfer'' of the ownership of the life insurance).

The latest form for Life Insurance Election expires 2021-06-30 and is listed under ICR 201803-3206-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SF 2817 Life Insurance ElectionForm and Instruction
OMB_Justification_SF2817_2022_03_07.docx Justification for No Material/Nonsubstantive Change
2021-03790.pdf Supplementary Document
SF2817_30DayFRN_Published_2021_07_12.pdf Supplementary Document
FACES 2017 FINAL 12212017signed.pdf Supplementary Document
ARS PIA Final 12212017signed.pdf Supplementary Document
Citations for SF 2817.pdf Supplementary Document
SF2817_OMBSupportingStmt_2021_06_16.docxSupporting Statement A
Life Insurance Election Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202203-3206-007 No material or nonsubstantive change to a currently approved collection 2022-03-07 Approved without change
202107-3206-001 Revision of a currently approved collection 2021-07-13 Approved with change
201803-3206-002 Reinstatement with change of a previously approved collection 2018-03-14 Approved with change
201408-3206-005 Revision of a currently approved collection 2014-08-29 Approved without change
201106-3206-009 Revision of a currently approved collection 2011-06-22 Approved without change
200904-3206-008 Reinstatement without change of a previously approved collection 2009-04-30 Approved without change
200508-3206-005 Extension without change of a currently approved collection 2005-08-19 Approved without change
200304-3206-001 Extension without change of a currently approved collection 2003-04-21 Approved without change
200003-3206-003 Reinstatement with change of a previously approved collection 2000-03-09 Approved without change
199902-3206-001 Revision of a currently approved collection 1999-02-22 Approved without change
199612-3206-003 New collection (Request for a new OMB Control Number) 1996-12-18 Approved without change