OMB control number
Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84
OMB 3206-0268 · OPM.
OMB 3206-0268
RI 20-126 is used to certify that an employee performed certain service with the District of Columbia (DC) that qualifies under section 1905 of PL 111-84 for determining retirement eligibility. However, this service cannot be used in the computation of a retirement benefit.
The latest form for Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 expires 2029-02-28 and is listed under ICR 202511-3206-005.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form RI120-126 Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 | Form and Instruction |
 RI20-126_OMBSupportingStmt_2025.docx | Supporting Statement A |
| E8-5659.pdf | Supplementary Document |
| E8-5659.pdf | Supplementary Document |
 Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 |
Form and Instruction |
| Certification of Qualifying District of Columbia Service Under Section 1905 of Public Law 111-84 |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202511-3206-005 | Revision of a currently approved collection | 2025-11-28 | ||
| 202211-3206-002 | Reinstatement without change of a previously approved collection | 2023-02-03 | Approved with change | |
| 201905-3206-003 | Reinstatement with change of a previously approved collection | 2019-06-10 | Approved with change | |
| 201510-3206-005 | New collection (Request for a new OMB Control Number) | 2015-10-29 | Approved with change |