FINANCIAL DISCLOSURE STATEMENT

ICR 198610-3220-001

OMB: 3220-0127

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
157699 Migrated
ICR Details
3220-0127 198610-3220-001
Historical Active 198604-3220-002
RRB
FINANCIAL DISCLOSURE STATEMENT
Revision of a currently approved collection   No
Regular
Approved without change 01/21/1987
Retrieve Notice of Action (NOA) 10/21/1986
  Inventory as of this Action Requested Previously Approved
12/31/1989 12/31/1989 12/31/1986
1,550 0 1,550
1,938 0 1,550
0 0 0

UNDER THE RAILROAD RETIREMENT AND RAILROAD UNEMPLOYMENT AND INSURANCE ACTS, THE BOARD HAS AUTHORITY TO SECURE FROM AN OVERPAID BENEFICIARY A STATEMENT OF THE INDIVIDUAL'S ASSETS AND LIABILITIES IF WAIVER OF THE OVERPAYMENT IS REQUESTED.

None
None


No

1
IC Title Form No. Form Name
FINANCIAL DISCLOSURE STATEMENT G-423

  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 1,550 1,550 0 0 0 0
Annual Time Burden (Hours) 1,938 1,550 0 388 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
10/21/1986


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