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OMB Control No: 3206-0136	ICR Reference No: 199605-3206-005
Status: Historical Active	Previous ICR Reference No: 199505-3206-001
Agency/Subagency: OPM	Agency Tracking No:
Title: Designation of Beneficiary - Federal Employees' Group Life Insurance Program
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/29/1996
	Date Received in OIRA: 05/30/1996
Terms of Clearance: In order to comply with the Paperwork Reduction Act, this form should be changed so that OPM complies with the requirement that it provides respondents with all information specified in 5 CFR 1320.8(b)(3). In addition--OPM may make the following change to the form: Reverse the position of the boxes dealing with "elected Living Benefits" and "I am the Insured/an Assignee" and add before "please check:" in the Living Benefits box the phrase "If the insured," so that it will read as follows: "If the insured, please check:". This change may be helpful to respondents since an assignee cannot elect living benefits.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/1999	07/31/1999
Responses	1,000	0	0
Time Burden (Hours)	250	0	0
Cost Burden (Dollars)	0	0	0

Abstract: This form is used by any Federal employee or retiree covered by the Federal Employees' Group Life Insurance to designate how to distribute the proceeds of his/her life insurance when the statutory order of precedence does not meet his/her needs.

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
Designation of Beneficiary - Federal Employees' Group Life Insurance Program	2823

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	1,000	1,000
Annual Time Burden (Hours)	250	250
Annual Cost Burden (Dollars)	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