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View ICR - OIRA Conclusion

OMB Control No: 3206-0162	ICR Reference No: 198811-3206-003
Status: Historical Active	Previous ICR Reference No: 198510-3206-003
Agency/Subagency: OPM	Agency Tracking No:
Title: REPORT OF MEDICAL EXAMINATION OF PERSON ELECTING SURVIVOR BENEFIT UNDER THE CIVIL SERVICE RETIREMENT SYSTEM
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/09/1989
	Date Received in OIRA: 11/29/1988
Terms of Clearance: PER AGREEMENT WITH LARRY DAMBROSE OF OPM, ONLY THE OMB ADDRESS WILL APPEAR IN THE BURDEN DISCLOSURE STATEMENT.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1991	12/31/1991	12/31/1988
Responses	2,000	0	1,400
Time Burden (Hours)	3,000	0	2,100
Cost Burden (Dollars)	0	0	0

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