RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0254 can be found here:

Documents and Forms

Document Name Document Type
Form RI 20-123 RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit Form and Instruction
RI 20-123 Request for Case Review for Enhanced Disability Annuity RI20-123_2011_05_MarkUp.pdf Form and Instruction
RI 20-123 Request for Case Review for Enhanced Disability Annuity RI 20-123_2020_01_Revised.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 20-123	Request for Case Review for Enhanced Disability Annuity Benefit	RI 20-123_2020_01_Revised.pdf		No		Paper Only
Form and Instruction	RI 20-123	Request for Case Review for Enhanced Disability Annuity Benefit	RI20-123_2011_05_MarkUp.pdf		No		Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM/Central-1	FR Citation: 73 FR 15013

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	100	0	0	100
Annual IC Time Burden (Hours)	8	0	0	8
Annual IC Cost Burden (Dollars)	0	-225	225	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.