Skip to Content


Submission for OMB Review; Comment Request for Reinstatement Without Change of an Information Collection

Document Details

Information about this document as published in the Federal Register.

Document Statistics
Document page views are updated periodically throughout the day and are cumulative counts for this document including its time on Public Inspection. Counts are subject to sampling, reprocessing and revision (up or down) throughout the day.
Published Document

This document has been published in the Federal Register. Use the PDF linked in the document sidebar for the official electronic format.

Start Preamble


Office of Personnel Management.




In accordance with the Paperwork Reduction Act of 1995 (Public Law 104-13, May 22, 1995), this notice announces that the Office of Personnel Management (OPM) has submitted to the Office of Management and Budget a request for reinstatement without change of an information collection. Standard Form 3112, CSRS/FERS Documentation in Support of Disability Retirement Application, 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.

Approximately 13,450 applicants for disability retirement complete Standard Forms 3112A and 3112C annually. The estimated breakdown for these responses are as follows: CSRS (10,000) and FERS (3,450). The SF 3112A requires approximately 30 minutes to complete and the SF 3112C requires approximately 60 minutes to complete. The annual burden is 12,775 hours.

For copies of this proposal, contact Mary Beth Smith-Toomey on (202) 606-8358, or E-mail to


Comments on this proposal should be received on or before September 11, 2000.


Send or deliver comments to—

Dennis A. Matteotti, Chief, Disability, Reconsideration and Appeals Division, Retirement and Insurance Service, U.S. Office of Personnel Management, 1900 E Street, NW., Room 3468, Washington, DC 20415-3550.


Joseph Lackey, OPM Desk Officer, Office of Information & Regulatory Affairs, Office of Management & Budget, New Executive Office Building, NW, Room 10235, Washington, DC 20503.


Donna G. Lease, Team Leader, Forms Analysis & Design, AMB, Budget & Administrative Services Division, (202) 606-0623.

Start Signature

U.S. Office of Personnel Management.

Janice R. Lachance,


End Signature End Preamble

[FR Doc. 00-20351 Filed 8-10-00; 8:45 am]