DISABILITY ANNUITANT'S REPORT TO THE U.S. RAILROAD RETIREMENT BOARD

ICR 197907-3220-012

OMB: 3220-0078

Federal Form Document

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Document
Name
Status
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ICR Details
3220-0078 197907-3220-012
Historical Active 197805-3220-013
RRB
DISABILITY ANNUITANT'S REPORT TO THE U.S. RAILROAD RETIREMENT BOARD
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 07/18/1979
Retrieve Notice of Action (NOA) 07/18/1979
  Inventory as of this Action Requested Previously Approved
10/31/1979 10/31/1979
3,000 0 0
250 0 0
0 0 0



None
None


No

1
IC Title Form No. Form Name
DISABILITY ANNUITANT'S REPORT TO THE U.S. RAILROAD RETIREMENT BOARD G-176B

  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 3,000 0 0 0 3,000 0
Annual Time Burden (Hours) 250 0 0 0 250 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.
07/18/1979


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