STATEMENT REGARDING ADOPTION

ICR 198205-3220-001

OMB: 3220-0040

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
157402 Migrated
ICR Details
3220-0040 198205-3220-001
Historical Active 198103-3220-018
RRB
STATEMENT REGARDING ADOPTION
Revision of a currently approved collection   No
Regular
Approved without change 06/25/1982
Retrieve Notice of Action (NOA) 05/17/1982
  Inventory as of this Action Requested Previously Approved
06/30/1985 06/30/1985 06/30/1982
600 0 400
150 0 100
0 0 0

THE RAILROAD RETIREMENT ACT PROVIDES FOR THE PAYMENT OF BENEFITS FOR A CHILD ALLEGED TO HAVE BEEN ADOPTED BY THE RAILROAD EMPLOYEE IF THE CHILD MEETS THE DEPENDENCY REQUIREMENTS UNDER THE ACT. THE STATEMENTS EXECUTED BY THE APPLICANT FILING ON THE CHILD'S BEHALF, OR OTHER PERSO IN SUPPORT OF THE APPLICATION, WILL BE USED FOR DETERMINING WHETHER TH CHILD IS ENTITLED TO BENEFITS.

None
None


No

1
IC Title Form No. Form Name
STATEMENT REGARDING ADOPTION G-118

  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 600 400 0 0 200 0
Annual Time Burden (Hours) 150 100 0 0 50 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.
05/17/1982


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