APPLICATION FOR EMPLOYEE ANNUITY UNDER THE RAILROAD RETIREMENT ACT

ICR 198305-3220-001

OMB: 3220-0002

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
3220-0002 198305-3220-001
Historical Active 198301-3220-002
RRB
APPLICATION FOR EMPLOYEE ANNUITY UNDER THE RAILROAD RETIREMENT ACT
Revision of a currently approved collection   No
Regular
Approved without change 06/03/1983
Retrieve Notice of Action (NOA) 05/03/1983
Approved with the following revisions to AA-1d: questions 16, 22 and 41.
  Inventory as of this Action Requested Previously Approved
05/31/1986 05/31/1986
34,800 0 0
15,560 0 0
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 RETIREMENT ACT AA-1, AA-1D, G-214, G-204

  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 34,800 0 0 0 34,800 0
Annual Time Burden (Hours) 15,560 0 0 0 15,560 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.
05/03/1983


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