OMB control number
Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits
OMB 3206-0233 · OPM.
OMB 3206-0233
RI 25-51 will be used by the Civil Service Retirement System solely to pay benefits to the widow(er) of an annuitant. This application is intended for use in immediately authorizing payments to an annuitant's widow or widower, based on the report of death, when our records show the decedent elected to provide benefits for the applicant. The Privacy Act Statement has been revised due to a systematic review by our Chief Privacy Officer.
The latest form for Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits expires 2023-11-30 and is listed under ICR 202010-3206-012.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form RI 25-51 Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits | Form and Instruction |
| E8-5659.pdf | Supplementary Document |
| RI25-051_2011-05_MarkUp.pdf | Supplementary Document |
| RI25-051_60DayFRN_Published_2020_03_23.pdf | Supplementary Document |
| RI25-051_30DayFRN_Published_2020_08_19.pdf | Supplementary Document |
 RI25-051_OMB_Support_Stmt_2020.docx | Supporting Statement A |
 Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits |
Form and Instruction |