View Information Collection Request (ICR) Package
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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:
3206-0140
ICR Reference No:
202404-3206-008
Status:
Active
Previous ICR Reference No:
202101-3206-005
Agency/Subagency:
OPM
Agency Tracking No:
RI 20-7/RI 30-3
Title:
Representative Payee Application/Information Necessary for a Competency Determination
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:
06/18/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/30/2024
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2027
36 Months From Approved
06/30/2024
Responses
12,480
0
12,480
Time Burden (Hours)
6,490
0
6,490
Cost Burden (Dollars)
174,418
0
174,418
Abstract:
RI 20-7, Representative Payee Application, is used by the Civil Service Retirement System (CSRS) and the Federal Employees Retirement System (FERS) to collect information from persons applying to be fiduciaries for minor children, annuitants, or survivor annuitants who appear to be incapable of handling their own funds. RI 30-3, Information Necessary for a Competency Determination, collects medical information regarding the annuitant's competency for OPM's use in evaluating the annuitant's condition.
Authorizing Statute(s):
US Code:
5 USC Chapter 83 Section 8345
Name of Law: CSRS, Payment of Benefits; commencement, termination, and waiver of annuity
US Code:
5 USC Chapter 84 Section 8466
Name of Law: FERS, Application for Benefits
US Code:
5 USC Chapter 83 Section 8344
Name of Law: CSRS, Annuities & Pay on Reemployment
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
3206-AO08
Final or interim final rulemaking
86 FR 57011
10/14/2021
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
86 FR 59434
10/27/2021
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 15105
03/10/2023
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
Representative Payee Application/Information Necessary for a Competency Determination
RI 30-3, RI 20-7
Information Necessary for a Competency Determination (2024, Mark Up)
,
Representative Payee Application (2024; Mark-Up)
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
12,480
12,480
0
0
0
0
Annual Time Burden (Hours)
6,490
6,490
0
0
0
0
Annual Cost Burden (Dollars)
174,418
174,418
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
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:
$198,850
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
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
04/30/2024
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