Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Death Gratuity Beneficiary Designation Modified 2600 650 0 Form and Instruction ca-40 Designation of a Recipient of a FECA Death Gratuity Payment under Section 1105 of Public Law 110-181 (Section 8102a)
Death Gratuity Official Notice of Employees' Death Modified 10 3 0 Form and Instruction ca-42 Official Notice of Employees' Death for Purposes of FECA Section 8102a Death Gratuity
Death Gratuity Claim for Survivor Benefits Modified 25 6 12 Form and Instruction ca-41 Claim for Survivor Benefits under FECA Section 8102a Death Gratuity
Total burden requested under this ICR: 2635 659 12  
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