Self-Certification of Full-Time School Attendance

ICR 202010-3206-001

OMB: 3206-0032

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2020-10-05
Supplementary Document
2020-10-05
Supplementary Document
2020-10-01
Supplementary Document
2020-10-01
Supplementary Document
2020-10-01
Supporting Statement A
2020-10-01
IC Document Collections
IC ID
Document
Title
Status
33544 Modified
ICR Details
3206-0032 202010-3206-001
Active 201703-3206-008
OPM RI 25-14, RI 25-14A
Self-Certification of Full-Time School Attendance
Revision of a currently approved collection   No
Regular
Approved without change 11/09/2020
Retrieve Notice of Action (NOA) 10/05/2020
  Inventory as of this Action Requested Previously Approved
11/30/2023 36 Months From Approved 11/30/2020
14,000 0 14,000
2,800 0 2,800
0 0 0

RI 25-14 is used to survey survivor annuitants who are between the ages of 18 and 22 to determine if they meet the requirements of Section 8341(a)(4)(C), and Section 8441, title 5, U.S. Code, to receive benefits as a student. RI 25-14A provides instructions for completing the Self-Certification of Full-Time School Attendance For The School Year survey form. The Privacy Act Statement has been revised due to a systematic review by our Chief Privacy Officer.

US Code: 5 USC 84, Section 8441 Name of Law: Definitions
   US Code: 5 USC 83, Section 8341 Name of Law: Survivor Annuities
  
None

Not associated with rulemaking

  85 FR 16394 03/23/2020
85 FR 43613 07/17/2020
No

  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 14,000 14,000 0 0 0 0
Annual Time Burden (Hours) 2,800 2,800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 -75,250 75,250 0
No
No

$35,300
No
    Yes
    Yes
No
No
No
No
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.
10/05/2020


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