APPLICATION FOR EMPLOYEE ANNUITY UNDER THE RAILROAD RETIRMENT ACT

ICR 198111-3220-003

OMB: 3220-0002

Federal Form Document

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Document
Name
Status
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IC Document Collections
ICR Details
3220-0002 198111-3220-003
Historical Active 197610-3220-003
RRB
APPLICATION FOR EMPLOYEE ANNUITY UNDER THE RAILROAD RETIRMENT ACT
Revision of a currently approved collection   No
Regular
Approved without change 02/01/1982
Retrieve Notice of Action (NOA) 11/16/1981
THIS REQUEST IS APPROVED UNTIL FEBRUARY 28, 1983. RRB MUST PROVIDE OMB WITH A REPORT OF THE RESULTS OF THE SELF-ADMINISTERED APPLICATIONS PILOT TEST BY JANUARY 1, 1983.
  Inventory as of this Action Requested Previously Approved
02/28/1983 02/28/1983 12/31/1981
42,760 0 44,000
16,940 0 17,000
0 0 0

THE RRA PROVIDES FOR PAYMENT OF AGE AND DISABILITY ANNUITIES TO QUALIFIED EMPLOYEES. THE APPLICATION OBTAINS INFORMATION ABOUT THE APPLICANT'S FAMILY, WORK HISTORY, MILITARY SERVICE, BENEFITS FROM OTHER GOVERNMENT AGENCIES AND PUBLIC OR PRIVATE PENSION. THE INFORMATION IS USED TO DETERMINE ENTITLEMENT TO AND AMOUNT OF ANNUITY APPLIED FOR.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR EMPLOYEE ANNUITY UNDER THE RAILROAD RETIRMENT ACT AA-4,, G-251, AA-1,, AA-1D,

  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 42,760 44,000 0 -82,667 81,427 0
Annual Time Burden (Hours) 16,940 17,000 0 -4,000 3,940 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
11/16/1981


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