To collect information needed to
establish a retired/retainer pay account for members of the
Uniformed Services who are retiring or reaching the age of
eligibility to receive retired pay. This includes designation of
beneficiaries for unpaid retired pay, state tax withholding
election, lump sum of retired pay election, information on
dependents, and election of Survivor Benefit Plan
coverage.
OMB Control Number 0704-0569
was approved on January 2, 2018, for emergency use. Since approval,
the Coast Guard asked to use the same form for its retiring
members. Approximately 1,800 Coast Guard members retire each year,
which increased the annual, approximate burden from 65,000
applicants to 66,800.
$340,012
No
Yes
Yes
No
No
No
Uncollected
Ben McAlduff 480 316-1398
benjamin.d.mcalduff.ctr@mail.mil
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.