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

ICR 198105-3220-016

OMB: 3220-0078

Federal Form Document

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ICR Details
3220-0078 198105-3220-016
Historical Active 198103-3220-032
RRB
DISABILITY ANNUITANT'S REPORT TO THE U S RAILROAD RETIREMENT BOARD
No material or nonsubstantive change to a currently approved collection   No
Emergency 05/28/1981
Approved with change 05/28/1981
Retrieve Notice of Action (NOA) 05/28/1981
  Inventory as of this Action Requested Previously Approved
07/31/1981 07/31/1981 05/31/1981
3,000 0 3,000
250 0 250
0 0 0

THE RAILROAD RETIREMENT ACT PROVIDES THAT DISABILITY BENEFITS ARE NOT PAYABLE FOR ANY MONTH IN WHICH THE ANNUITANT RETURNS TO WORK FOR A RAILROAD OR LAST NON-RAILROAD EMPLOYER OR RECEIVED EXCESSIVE EARNINGS FROM EMPLOYMENT OR SELF-EMPLOYMENT. AT THE TIME OF FILING FOR DISABILITY BENEFITS, THE APPLICANT IS FURNISHED A BOOKLET ON WORK RESTRICTIONS WHICH INCLUDES A FORM FOR REPORTING SUCH EMPLOYMENT. THE INFORMATION WILL BE USED FOR DETERMINING CONTINUE

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 3,000 0 0 0 0
Annual Time Burden (Hours) 250 250 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.
05/28/1981


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