SUPPLEMENTAL ANNUITY QUESTIONNAIRE

ICR 198102-3220-008

OMB: 3220-0089

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
157581 Migrated
ICR Details
3220-0089 198102-3220-008
Historical Active 198012-3220-004
RRB
SUPPLEMENTAL ANNUITY QUESTIONNAIRE
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 02/28/1981
Retrieve Notice of Action (NOA) 02/19/1981
  Inventory as of this Action Requested Previously Approved
03/31/1981 03/31/1981
2,000 0 0
333 0 0
0 0 0

THE RAILROAD RETIREMENT ACT PROVIDES FOR PAYMENT OF A SUPPLEMENTAL ANNUITY TO A QUALIFIED RETIREMENT ANNUITANT BASED ON AGE, LENGTH OF RAILROAD SERVICE AND A CURRENT CONNECTION WITH THE RAILROAD INDUSTRY. THE QUESTIONNAIRE WILL OBTAIN INFORMATION ON THE REQUIREMENTS FOR THE ANNUITY AS PRESCRIBED UNDER THE ACT. THE INFORMATION WILL BE USED FOR DETERMINING ENTITLEMENT TO AND THE AMOUNT OF ANNUITY APPLIED FOR.

None
None


No

1
IC Title Form No. Form Name
SUPPLEMENTAL ANNUITY QUESTIONNAIRE AA-1 SUP

  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 2,000 0 0 0 2,000 0
Annual Time Burden (Hours) 333 0 0 0 333 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.
02/19/1981


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