ADDENDUM TO OPM 1496A

ICR 198509-3206-001

OMB: 3206-0161

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
156993 Migrated
ICR Details
3206-0161 198509-3206-001
Historical Active
OPM
ADDENDUM TO OPM 1496A
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/19/1985
Retrieve Notice of Action (NOA) 09/16/1985
This form will be used only until OPM 1496B form is available for use.
  Inventory as of this Action Requested Previously Approved
12/31/1985 12/31/1985
4,000 0 0
1,340 0 0
0 0 0

THE ADDENDUM COLLECTS INFORMATION REGARDING EX-SPOUSES ELIGIBILITY FOR SURVIVOR BENEFITS IN CASES OF DEFERRED RETIREMENTS UNDER THE CIVIL SERVICE RETIREMENT SYSTEM. THE FORM WILL BE USED ONLY UNTIL OPM 1496B APPLICATION FOR DEFERRED RETIREMENT FOR ANNUITIES COMMENCING ON OR AFT MAY 7, 1985, IS AVAILABLE FOR USE.

None
None


No

1
IC Title Form No. Form Name
ADDENDUM TO OPM 1496A BRI 46-437

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,000 0 0 4,000 0 0
Annual Time Burden (Hours) 1,340 0 0 1,340 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/16/1985


© 2024 OMB.report | Privacy Policy