View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 3206-0172	ICR Reference No: 199406-3206-010
Status: Historical Active	Previous ICR Reference No: 199110-3206-004
Agency/Subagency: OPM	Agency Tracking No:
Title: APPLICATION FOR DEATH BENEFITS (FERS), SURVIVOR SUPPLEMENT (FERS), AND DOCUMENTATION OF ELECTIONS IN SUPPORT OF APPLICATION FOR DEATH BENEFITS WHEN DECEASED WAS AN ...
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: 09/20/1994
	Date Received in OIRA: 06/30/1994
Terms of Clearance: For OPM's consideration, OMB has provided under seperate cover a number of minor suggestions for changes to increase clarity. OPM should provide to OMB a new version of this form indicating those changes it has adopted.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1997	06/30/1997	06/30/1994
Responses	6,312	0	3,926
Time Burden (Hours)	6,312	0	3,926
Cost Burden (Dollars)	0	0	0

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