APPLICATION FOR EMPLOYEE ANNUITY UNDER THE RAILROAD RETIREMENT ACT

ICR 197610-3220-003

OMB: 3220-0002

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
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ICR Details
3220-0002 197610-3220-003
Historical Active 197512-3220-006
RRB
APPLICATION FOR EMPLOYEE ANNUITY UNDER THE RAILROAD RETIREMENT ACT
Revision of a currently approved collection   No
Regular
Approved without change 10/19/1976
Retrieve Notice of Action (NOA) 10/13/1976
  Inventory as of this Action Requested Previously Approved
10/31/1981 10/31/1981 09/30/1977
36,000 0 40,000
15,000 0 20,000
0 0 0

SECTION 2 OF THE RAILROAD RETIREMENT ACT PROVIDES FOR PAYMENT OF AGE AND DISABILITY EMPLOYEE ANNUITIES TO QUALIFIED INDIVIDUALS IN THE AMOUNTS PRESCRIBED IN SECTION 3 OF THE ACT. THE APPLICATION WILL OBTAIN INFORMATION ABOUT THE APPLICANT'S FAMILY, WORK HISTORY, MILITARY SERVICE, BENEFITS FROM OTHER GOVERNMENT AGENCIES AND RAILROAD PENSION. THE FORMATION WILL BE USED FOR DETERMINING ENTITLEMENT TO AND AMOUNT OF ANNUITY APPLIED FOR

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR EMPLOYEE ANNUITY UNDER THE RAILROAD RETIREMENT ACT AA-1

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 36,000 40,000 0 0 -4,000 0
Annual Time Burden (Hours) 15,000 20,000 0 0 -5,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/13/1976


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