AUTHORIZATION OF PAYMENT AND RELEASE OF ALL CLAIMS TO A DEATH BENEFIT OR ACCRUED ANNUITY PAYMENT

ICR 198005-3220-003

OMB: 3220-0041

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
3220-0041 198005-3220-003
Historical Active 197904-3220-002
RRB
AUTHORIZATION OF PAYMENT AND RELEASE OF ALL CLAIMS TO A DEATH BENEFIT OR ACCRUED ANNUITY PAYMENT
Extension without change of a currently approved collection   No
Regular
Approved without change 05/19/1980
Retrieve Notice of Action (NOA) 05/01/1980
  Inventory as of this Action Requested Previously Approved
05/31/1981 05/31/1981 05/31/1980
700 0 700
117 0 117
0 0 0

THE RAILROAD RETIREMENT ACT PROVIDES THAT AN INDIVIDUAL ENTITLED TO SHARE IN LUMP SUM DEATH BENEFITS MAY DESIGNATE PAYMENT OF SUCH SHARE TO ANOTHER ELIGIBLE PERSON OR PERSONS. THE AUTHORIZATION EXECUTED BY THE INDIVDUAL WILL OBTAIN INFORMATION ON THE PERSON OR PERSONS TO RECEIVE THE BENEFIT.

None
None


No

1
IC Title Form No. Form Name
AUTHORIZATION OF PAYMENT AND RELEASE OF ALL CLAIMS TO A DEATH BENEFIT OR ACCRUED ANNUITY PAYMENT G-131

  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 700 700 0 0 0 0
Annual Time Burden (Hours) 117 117 0 0 0 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.
05/01/1980


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