Application to Make Deposit or Redeposit (CSRS)/Application to Make Service Credit Payment for Civilian Service (FERS)

Forms and Documents

Document Name	Status
Form SF 2803 Application to Make Deposit or Redeposit (CSRS)/Application to Make Service Credit Payment (FERS) Form and Instruction	Modified
SF 3108 August 2013 Markup.pdf Supplementary Document	2013-03-28
SF 3108 February 2012 Markup.pdf Supplementary Document	2013-03-28
SF 2803 Aug 2013 Markup.pdf Supplementary Document	2013-03-28
SF 2803 April 2010 Markup.pdf Supplementary Document	2013-03-28
30-Day FRN.pdf Supplementary Document	2013-03-28
60-day FRN.pdf Supplementary Document	2013-03-28
Supporting Statement.doc Supporting Statement A	2013-03-28

IC Document Collections

IC ID	Document Title	Status
33597	Application to Make Deposit or Redeposit (CSRS)/Application to Make Service Credit Payment (FERS) Form and Instruction	Modified

ICR Details

OMB Control No: 3206-0134	ICR Reference No: 201303-3206-006
Status: Historical Active	Previous ICR Reference No: 201105-3206-006
Agency/Subagency: OPM	Agency Tracking No:
Title: Application to Make Deposit or Redeposit (CSRS)/Application to Make Service Credit Payment for Civilian Service (FERS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/30/2013
	Date Received in OIRA: 03/28/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2016	36 Months From Approved	07/31/2013
Responses	150	0	150
Time Burden (Hours)	75	0	75
Cost Burden (Dollars)	0	0	0

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Abstract: SF 2803/SF 3108 are an application to make payment used by persons who are eligible to pay for Federal service which was not subject to retirement deductions and/or for Federal service which was subject to retirement deduction which were subsequently refunded to the applicant. The forms were revised to update the Public Burden Statement and our TTY number. We have annotated the edits on this forms.

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Authorizing Statute(s): US Code: 5 USC Chapter 83, Section 8334 Name of Law: CSRS
   US Code: 5 USC Chapter 84, Section 8411 Name of Law: FERS
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 73061	12/07/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 19027	03/28/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application to Make Deposit or Redeposit (CSRS)/Application to Make Service Credit Payment (FERS)	SF 2803, SF 3108	Application to Make Deposit or Redeposit (CSRS) ,   Application to Make Service Credit Payment for Civilian Service (FERS)

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ICR Summary of Burden

	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	150	150	0	0	0	0
Annual Time Burden (Hours)	75	75	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $2,800

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/28/2013

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