Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....

OMB: 3206-0174

IC ID: 33658

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0174 can be found here:

2024-06-30 - Revision of a currently approved collection

Documents and Forms

Document Name Document Type
Form RI 20-117_ROC Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the.... Form and Instruction
RI 20-63 Survivor Annuity Election for a Spouse RI20-063_2018_02.pdf Form and Instruction
RI 20-63 Survivor Annuity Election for a Spouse RI20-063_2018_02.pdf Form and Instruction
RI 20-116 Information about the Cost to Elect Less Than the Maximu RI20-116_2016_08_DC_MarkUp.pdf Form and Instruction
RI 20-116 Information about the Cost to Elect Less Than the Maximu RI20-116_2016_08_DC_MarkUp.pdf Form and Instruction
RI 20-116 Information about the Cost to Elect Less Than the Maximu RI20-116_2021_02_DC_Revised.pdf Form and Instruction
RI 20-116 Information about the Cost to Elect Less Than the Maximu RI20-116_2021_02_DC_Revised.pdf Form and Instruction
RI 20-117_DC Information about the Cost to Elect the Maximum Survivor RI20-117_2016_08_DC_MarkUp.pdf Form and Instruction
RI 20-117_DC Information about the Cost to Elect the Maximum Survivor RI20-117_2016_08_DC_MarkUp.pdf Form and Instruction
RI 20-117_DC Information about the Cost to Elect teh Maximum Survivor RI20-117_2021_02_DC_Revised.pdf Form and Instruction
RI 20-117_DC Information about the Cost to Elect teh Maximum Survivor RI20-117_2021_02_DC_Revised.pdf Form and Instruction
RI 20-117_ROC Survivor Annuity Election for a Spouse RI20-117_2016_08_ROC_Mark Up.pdf Form and Instruction
RI 20-117_ROC Survivor Annuity Election for a Spouse RI20-117_2016_08_ROC_Mark Up.pdf Form and Instruction
RI 20-63 Survivor Annuity Election for a Spouse RI20-063_2021_02_Revised.pdf Form and Instruction
RI 20-63 Survivor Annuity Election for a Spouse RI20-063_2021_02_Revised.pdf Form and Instruction
RI 20-117_ROC Information about the Cost to Elect the Maximum Survivor RI20-117_2021_02_ROC_Revised.pdf Form and Instruction
RI 20-117_ROC Information about the Cost to Elect the Maximum Survivor RI20-117_2021_02_ROC_Revised.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survivor Annuity Election for a Spouse/Cover Letter Giving Information About the Cost to Elect Less Than the Maximum Survivor Annuity/Cover Letter Giving Information About the....	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 842.612 5 CFR 831.631 5 CFR 842.613 5 CFR 842.614 5 CFR 842.611 5 CFR 842.615 5 CFR 831.632

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	RI 20-63	Survivor Annuity Election for a Spouse	RI20-063_2018_02.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-116	Information about the Cost to Elect Less Than the Maximum Survivor Annuity	RI20-116_2016_08_DC_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-116	Information about the Cost to Elect Less Than the Maximum Survivor Annuity	RI20-116_2021_02_DC_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-117_DC	Information about the Cost to Elect the Maximum Survivor Annuity	RI20-117_2016_08_DC_MarkUp.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-117_DC	Information about the Cost to Elect teh Maximum Survivor Annuity	RI20-117_2021_02_DC_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-117_ROC	Survivor Annuity Election for a Spouse	RI20-117_2016_08_ROC_Mark Up.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-63	Survivor Annuity Election for a Spouse	RI20-063_2021_02_Revised.pdf	Yes	No	Fillable Printable
Form and Instruction	RI 20-117_ROC	Information about the Cost to Elect the Maximum Survivor Annuity	RI20-117_2021_02_ROC_Revised.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OPM/Central-1	FR Citation: 75 FR 15013

Number of Respondents: 2,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,400	0	2,400
Annual IC Time Burden (Hours)	1,834	0	1,834
Annual IC Cost Burden (Dollars)	49,290	49,290	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.