Daily Rules, Proposed Rules, and Notices of the Federal Government


Submission for Review: 3206-0228, CSRS/FERS Documentation in Support of Disability Retirement Application, SF 3112

AGENCY: U.S. Office of Personnel Management.
ACTION: 60-Day Notice and request for comments.
SUMMARY: 1. Evaluate whether the proposed collection of information is necessary for the proper performance of functions of the agency, including whether the information will have practical utility;

2. Evaluate the accuracy of the agency's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used;

3. Enhance the quality, utility, and clarity of the information to be collected; and

4. Minimize the burden of the collection of information on those who are to respond, including through the use of appropriate automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submissions of responses.

DATES: Comments are encouraged and will be accepted until January 2, 2013. This process is conducted in accordance with 5 CFR 1320.1.
ADDRESSES: Interested persons are invited to submit written comments on the proposed information collection to U.S. Office of Personnel Management, Retirement Services, Union Square 370, 1900 E Street NW., Washington, DC 20415-3500, Attention: Alberta Butler or sent via electronic mail
FOR FURTHER INFORMATION CONTACT: A copy of this ICR with applicable supporting documentation may be obtained by contacting the Retirement Services Publications Team, Office of Personnel Management, 1900 E Street NW., Room 4332, Washington, DC 20415, Attention: Cyrus S. Benson, or sent via electronic mail toCyrus.Benson@opm.govor faxed to (202) 606-0910.

SF 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.


Agency:Retirement Operations, Retirement Services, Office of Personnel Management.

Title:CSRS/FERS Documentation in Support of Disability Retirement Application.

OMB Number:3206-0228.

Frequency:On occasion.

Affected Public:Individuals or Households.

Number of Respondents:SF 3112A = 1,350; SF 3112C = 12,100.

Estimated Time per Respondent:SF 3112A = 30 minutes; SF 3112C = 60 minutes.

Total Burden Hours:12,775.

U.S. Office of Personnel Management. John Berry, Director.