View Information Collection Request (ICR) Package

OMB Control No: 3206-0032	ICR Reference No: 199105-3206-001
Status: Historical Active	Previous ICR Reference No: 199005-3206-001
Agency/Subagency: OPM	Agency Tracking No:
Title: SELF-CERTIFICATION OF FULL-TIME SCHOOL ATTENDANCE
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/14/1991
	Date Received in OIRA: 05/10/1991
Terms of Clearance: This request, as amended by the additional material provided to OMB on 6/11/91, is approved for use through 4/92. This approval is conditional upon the following: 1. These forms be used consistant with the manner described in the memorandum of 5/3/91 from Carol Johnson and Joe Lackey of OMB to Ellie Goodwin and Jim Freiert of OPM. 2. In its title and all references the survey of adult student enrollment will be called: "Student Enrollment Status Questionnaire." 3. That a single Privacy Act and Public Burden Statement appear on the cover letter accompanying both forms or that each form seperately contain Privacy Act and Public Burden Statements. This request is being given a limited term approval in order that the success of this approach to identifying overpayments can be assessed prior to the 1992-93 academic year.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/1992	04/30/1992	05/31/1991
Responses	14,000	0	14,000
Time Burden (Hours)	6,300	0	2,800
Cost Burden (Dollars)	0	0	0

Abstract: RI 25-14 IS DESIGNED TO COLLECT INFORMATION ABOUT MARITAL STATUS AND SCHOOL ENROLLMENT FOR STUDENT SURVIVOR ANNUITANTS. THIS FORM IS USED B THE RETIREMENT AND INSURANCE GROUP TO DETERMINE WHETHER A SURVIVING CHILD OF DECEASED FEDERAL EMPLOYEE IS ELIGIBLE TO RECEIVE BENEFITS AS STUDENT.

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
SELF-CERTIFICATION OF FULL-TIME SCHOOL ATTENDANCE	RI 25-14

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	14,000	14,000	0
Annual Time Burden (Hours)	6,300	2,800	3,500
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

View ICR - OIRA Conclusion