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Employee's Statement Of Service Performed Before Jan. 1, 1937, To Employers Under The Rr Act

IC 176852 under ICR 198103-3220-009 · OMB 3220-0006.

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EMPLOYEE'S STATEMENT OF SERVICE PERFORMED BEFORE JAN. 1, 1937, TO EMPLOYERS UNDER THE RR ACT
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form AA-15 No No


    

2,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,000 0 0 0 0 2,000
Annual IC Time Burden (Hours) 500 0 0 0 0 500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.