Flags Request Form

Forms and Documents

Document Name	Status
Form OPM 1825 OPM 1825 Form and Instruction	New
Supporting Statement for OPM1825.DOC.doc Supporting Statement A	2014-03-13
2014-05277 30 day notice.pdf Supplementary Document	2014-03-12
2013-14087 60 day notice.pdf Supplementary Document	2014-03-12

IC Document Collections

IC ID	Document Title	Status
210682	OPM 1825 Form and Instruction	New

ICR Details

OMB Control No: 3206-0264	ICR Reference No: 201403-3206-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: OPM	Agency Tracking No:
Title: Flags Request Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 06/13/2014
	Date Received in OIRA: 03/13/2014
Terms of Clearance: OPM will need to submit the ICR when the final rule is submitted for OMB approval.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Civilian Service Recognition Act of 2011 (Public Law 112-73) authorizes an agency to furnish a United States flag on behalf of an employee who dies of injuries incurred in connection with his/her employment under specified circumstances. OPM Form OPM 1825, Application for U.S. Flag Recognition Benefit for Deceased Federal Civilian Employees, may be used to determine deceased Federal employee and beneficiary (e.g., family member of a deceased employee) eligibility for issuance of a U.S. flag. The form may be used by any Federal entity and use of the form is at agency discretion.

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Authorizing Statute(s): PL: Pub.L. 112 - 73 2 Name of Law: Civilian Service Recognition Act of 2011
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3206-AM58	Proposed rulemaking	78 FR 36311	06/17/2013

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 36311	06/17/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 13687	03/11/2014
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
OPM 1825	OPM 1825	APPLICATION FOR U.S. FLAG RECOGNITION BENEFIT FOR DECEASED FEDERAL CIVILIAN EMPLOYEES

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: OPM issued 3206-AM58 providing guidance to agencies to authorize agencies to furnish a United States flag on behalf of an employee who dies of injuries incurred in connection with his/her employment under specified circumstances. The burden increase is due to the creation of this program.

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Annual Cost to Federal Government: $0

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:  Yes

Description/Changes for Common Form Usage:  Agencies can change addresses if necessary

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 03/13/2014

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