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OMB Control No: 3206-0042	ICR Reference No: 202511-3206-003
Status: Received in OIRA	Previous ICR Reference No: 202210-3206-002
Agency/Subagency: OPM	Agency Tracking No: RI 25-15
Title: Survey of Student's Eligibility to Receive Benefits
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 11/28/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2026
Responses	4,264	2,500
Time Burden (Hours)	1,421	835
Cost Burden (Dollars)	51,191	19,543

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	4,264	2,500	1,764
Annual Time Burden (Hours)	1,421	835	586
Annual Cost Burden (Dollars)	51,191	19,543	31,648

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden has changed due to combining forms into one, which slightly affected the respondent numbers. There has also been slight changes due to shifts with inflation.

Annual Cost to Federal Government: $43,900

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: Alexys Stanley 202 606-1183 alexys.stanley@opm.gov