View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 3206-0128	ICR Reference No: 202101-3206-006
Status: Historical Active	Previous ICR Reference No: 201712-3206-016
Agency/Subagency: OPM	Agency Tracking No: SF 2802/SF 2802A
Title: Application for Refund of Retirement Deductions (CSRS) Current/Former Spouse's Notification of Application for Refund
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: 03/20/2021
	Date Received in OIRA: 01/29/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2024	36 Months From Approved	03/31/2021
Responses	7,130	0	7,130
Time Burden (Hours)	4,588	0	4,588
Cost Burden (Dollars)	135,308	0	0

Annual Cost to Federal Government: $20,360

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Charles Conyers 202 606-0125 charles.conyers@opm.gov

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