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Authorization Of Payment And Release Of All Claims To A Death Benefit Or Accrued Annuity Payment
AUTHORIZATION OF PAYMENT AND RELEASE OF ALL CLAIMS TO A DEATH BENEFIT OR ACCRUED ANNUITY PAYMENT
OMB: 3220-0041
IC ID: 157409
OMB.report
RRB
OMB 3220-0041
ICR 198005-3220-003
IC 157409
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0041 can be found here:
1980-05-19 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
AUTHORIZATION OF PAYMENT AND RELEASE OF ALL CLAIMS TO A DEATH BENEFIT OR ACCRUED ANNUITY PAYMENT
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
G-131
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
700
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
700
0
0
0
0
700
Annual IC Time Burden (Hours)
117
0
0
0
0
117
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.