View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 3206-0143	ICR Reference No: 202403-3206-001
Status: Historical Inactive	Previous ICR Reference No: 202101-3206-008
Agency/Subagency: OPM	Agency Tracking No: RI 30-1
Title: Request to Disability Annuitant for Information on Physical Condition and Employment
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 04/04/2024
	Date Received in OIRA: 03/29/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2024	36 Months From Approved	06/30/2024
Responses	8,000	0	8,000
Time Burden (Hours)	8,000	0	8,000
Cost Burden (Dollars)	215,000	0	215,000

Annual Cost to Federal Government: $93,900

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: Demetrius Jones 202 606-5203 demetrius.jones@opm.gov

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