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.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SF 2817 Life Insurance ElectionForm and Instruction
Form SF 2817 Life Insurance ElectionForm and Instruction
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
Life Insurance Election Form and Instruction
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All Historical Document Collections

Historical document collections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