OMB has given a
limited term approval to this request during which time OPM is to
consider several modifications suggested by OMB. During this period
OPM may continue to use the current version of the form without
making those changes indicated in its request.If OPM resubmits a
request for approval of this form addressing the OMB suggested
modifications prior to the end of 9/93, OMB waives the requirement
for further public notification of this continuing review based
upon OPM having published a notice in the Federal Registe during
March 1993.
Inventory as of this Action
Requested
Previously Approved
12/31/1993
12/31/1993
05/31/1993
3,000
0
3,000
250
0
250
0
0
0
THIS FORM IS USED BY THE CIVIL SERVICE
RETIREMENT SYSTEM AND THE FEDER EMPLOYEES RETIREMENT SYSTEM TO
IDENTIFY THE RECORDS OF INDIVIDUALS WIT SIMILAR OR THE SAME NAMES.
IT IS ALSO NEEDED TO REPORT PAYMENTS TO TH INTERNAL REVENUE
SERVICE.
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.