RI 20-120, Request for Change to Unreduced Annuity

ICR 201201-3206-003

OMB: 3206-0245

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2012-01-04
Supplementary Document
2012-01-04
Supplementary Document
2012-01-04
Supplementary Document
2012-01-04
Supporting Statement A
2012-01-04
IC Document Collections
IC ID
Document
Title
Status
33770 Modified
ICR Details
3206-0245 201201-3206-003
Historical Active 200906-3206-001
OPM
RI 20-120, Request for Change to Unreduced Annuity
Revision of a currently approved collection   No
Regular
Approved without change 02/26/2012
Retrieve Notice of Action (NOA) 01/26/2012
  Inventory as of this Action Requested Previously Approved
02/28/2015 36 Months From Approved 07/31/2012
5,000 0 5,000
2,500 0 2,500
0 0 0

RI 20-120 collects information from annuitants whose marriages have ended and who request an annuity paid at the unreduced rate without provisions for a survivor benefit. The form has been revised to bring it up-to-date.

US Code: 5 USC Section 8419(b) Name of Law: Survivor reductions; Computation
   US Code: 5 USC Section 8339(j)(5)(A) and (B) Name of Law: Computation of Annuity
  
None

Not associated with rulemaking

  76 FR 32997 06/07/2011
76 FR 82000 12/29/2011
No

1
IC Title Form No. Form Name
RI 20-120, Request for Change to Unreduced Annuity RI 20-120 Request for Change to Unreduced Annuity

  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 5,000 5,000 0 0 0 0
Annual Time Burden (Hours) 2,500 2,500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$36,800
No
No
No
No
No
Uncollected
Miles Windsor 202 606-8358 miles.windsor@opm.gov

  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.
01/26/2012


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