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Referral Card - Report On Placement Or Refusal Of Referral Or Offer To Railroad Retirement Board

IC 176920 under ICR 198104-3220-007 · OMB 3220-0027.

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REFERRAL CARD - REPORT ON PLACEMENT OR REFUSAL OF REFERRAL OR OFFER TO RAILROAD RETIREMENT BOARD
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form ES-21 & No No
Form ES-21C No No
Form ES-21, No No
Form ES-21C No No


    

21,000 0
   
State, Local, and Tribal Governments
 
   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 26,000 0 5,000 0 0 21,000
Annual IC Time Burden (Hours) 883 0 0 0 0 883
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.