View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 3206-0141	ICR Reference No: 201603-3206-001
Status: Historical Active	Previous ICR Reference No: 201308-3206-001
Agency/Subagency: OPM	Agency Tracking No:
Title: OPM 2809, Health Benefits Election Form
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: 03/30/2017
	Date Received in OIRA: 03/03/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2020	36 Months From Approved	03/31/2017
Responses	30,000	0	30,000
Time Burden (Hours)	11,667	0	11,667
Cost Burden (Dollars)	0	0	0

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