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

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Office of Personnel Management.


30-Day notice and request for comments.


Retirement Services, Office of Personnel Management (OPM) offers the general public and other federal agencies the opportunity to comment on an expiring information collection request (ICR) with minor edits, CSRS/FERS Documentation in Support of Disability Retirement Application, Standard Form 3112.


Comments are encouraged and will be accepted until March 29, 2021.


Interested persons are invited to submit written comments on the proposed information collection to the Office of Information and Regulatory Affairs, Office of Management and Budget, 725 17th Street NW, Washington, DC 20503, Attention: Desk Officer for the Office of Personnel Management or sent via electronic mail to: or faxed to (202) 395-6974.

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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 3316-L, Washington, DC 20415, Attention: Cyrus S. Benson, or sent via electronic mail to or faxed to (202) 606-0910 or via telephone at (202) 606-4808.

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As required by the Paperwork Reduction Act of 1995 OPM is soliciting comments for this collection. The information collection (OMB No. 3206-0228) was previously published in the Federal Register on June 1, 2020 at 85 FR 33205, allowing for a 60-day public comment period. No comments were received.

The Office of Management and Budget is particularly interested in comments that:

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.

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 under title 5, U.S.C. Sections 8337 and 8455. 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.

OMB Number: 3206-0228.

Frequency: On occasion.

Affected Public: Individuals or Households.

Number of Respondents: 13,450 [1,350 (SF 3112A) and 12,100 (SF 3112C)].

Estimated Time per Respondent: 30 minutes (SF 3112A) and 60 minutes (SF 3112C).

Total Burden Hours: 12,775 hours [675 hours (SF 3112A) and 12,100 hours (SF 3112C)].

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Office of Personnel Management.

Alexys Stanley,

Regulatory Affairs Analyst.

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[FR Doc. 2021-03964 Filed 2-25-21; 8:45 am]