[Federal Register Volume 74, Number 217 (Thursday, November 12, 2009)]
[Notices]
[Page 58325]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-27139]


-----------------------------------------------------------------------

OFFICE OF PERSONNEL MANAGEMENT


Proposed Collection; Comment Request for Review of a Revised 
Information Collection: (OMB Control No. 3206-0228; Standard Form 3112)

AGENCY: Office of Personnel Management.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Pub. 
L. 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management (OPM) intends to submit to the Office of 
Management and Budget (OMB) a request for review of a revised 
information collection. This information collection, ``CSRS/FERS 
Documentation in Support of Disability Retirement Application'' (OMB 
Control No. 3206-0228; Standard Form 3112), collects information from 
applicants for disability retirement so that OPM can determine whether 
to approve a disability retirement. The applicant will only complete 
Standard Forms 3112A and 3112C. Standard Forms 3112B, 3112D and 3112E 
will be completed by the immediate supervisor and the employing agency 
of the applicant.
    Comments are particularly invited on: Whether this collection of 
information is necessary for the proper performance of functions of the 
OPM, and whether it will have practical utility; whether our estimate 
of the public burden of this collection of information is accurate, and 
based on valid assumptions and methodology; and ways in which we can 
minimize the burden of the collection of information on those who are 
to respond, through the use of appropriate technological collection 
techniques or other forms of information technology.
    Approximately 12,100 applicants for disability retirement complete 
this application annually. The SF 3112C requires approximately 60 
minutes to complete. A burden of 12,100 hours is estimated for SF 
3112C. SF 3112A is used each year by approximately 1,350 persons who 
are not Federal employees. SF 3112A requires approximately 30 minutes 
to complete and a burden of 675 hours is estimated for SF 3112A.
    All 12,100 respondents must use SF 3112C; of the 12,100, only 1,350 
of the applicants are not Federal Employees and use SF 3112A. The total 
annual burden for SF 3112 is 12,775 hours.
    For copies of this proposal, contact Cyrus S. Benson on (202) 606-
4808, FAX (202) 606-0910 or via E-mail to [email protected]. Please 
include a mailing address with your request.

DATES: Comments on this proposal should be received within 60 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to--James K. Freiert, Deputy 
Assistant Director, Retirement Services Program, Center for Retirement 
and Insurance Services, U.S. Office of Personnel Management, 1900 E 
Street, NW., Room 3305, Washington, DC 20415-3500.
    For information regarding administrative coordination contact: 
Cyrus S. Benson, Team Leader, Publications Team, RIS Support Services/
Support Group, U.S. Office of Personnel Management, 1900 E Street, NW., 
Room 4H28, Washington, DC 20415, (202) 606-0623.

U.S. Office of Personnel Management.
John Berry,
Director.
[FR Doc. E9-27139 Filed 11-10-09; 8:45 am]
BILLING CODE 6325-38-P