RI 38-115, Representative Payee Survey

ICR 201706-3206-001

OMB: 3206-0208

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2017-06-13
Supporting Statement A
2017-06-13
Supplementary Document
2017-06-12
Supplementary Document
2017-06-12
IC Document Collections
IC ID
Document
Title
Status
33701 Modified
ICR Details
3206-0208 201706-3206-001
Historical Active 201405-3206-001
OPM
RI 38-115, Representative Payee Survey
Extension without change of a currently approved collection   No
Emergency 07/31/2017
Approved without change 10/02/2017
Retrieve Notice of Action (NOA) 06/13/2017
  Inventory as of this Action Requested Previously Approved
04/30/2018 08/31/2017 09/30/2017
11,000 0 11,000
3,667 0 3,667
0 0 0

RI 38-115 is designed to collect information about how the benefits paid to a representative payee have been used or conserved for the benefit of the incompetent annuitant. Editorial changes were made to this ICR, including the addition of a field to capture the certification of a Notary Public.
The collection expires on June 30, 2017 prior to the end of the 30 Day FRN on July 10, 2017.

US Code: 5 USC Chapter 83, Section 8347(a) Name of Law: CSRS, Administration; regulations
   US Code: 5 USC Chapter 83, Section 8345(e) Name of Law: CSRS, Payment of benefits; commencement, termination, and waiver of annuity
   US Code: 5 USC Chapter 84, Section 8466(c) Name of Law: FERS, Application for Benefits
   US Code: 5 USC Chapter 84, Section 8461(g) Name of Law: FERS, Authority of the Office of Personnel Management.
  
None

Not associated with rulemaking

  81 FR 180 09/16/2016
82 FR 26817 06/09/2017
No

1
IC Title Form No. Form Name
Representative Payee Survey RI 38-115 Representative Payee Survey

  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 11,000 11,000 0 0 0 0
Annual Time Burden (Hours) 3,667 3,667 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$34,800
No
    Yes
    Yes
No
No
No
Uncollected
Charles Conyers 202 606-0125 charles.conyers@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.
06/13/2017


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