RAILROAD VERIFICATION OF CLAIMED UNEMPLOYMENT OR SICKNESS

ICR 198904-3220-007

OMB: 3220-0153

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
3220-0153 198904-3220-007
Historical Active 198607-3220-005
RRB
RAILROAD VERIFICATION OF CLAIMED UNEMPLOYMENT OR SICKNESS
No material or nonsubstantive change to a currently approved collection   No
Emergency 04/04/1989
Approved with change 04/04/1989
Retrieve Notice of Action (NOA) 04/04/1989
  Inventory as of this Action Requested Previously Approved
10/31/1989 10/31/1989 10/31/1989
20,200 0 20,200
786 0 786
0 0 0

THE NOTICES PROVIDE THE MEANS WHEREBY EMPLOYERS CAN ADVISE THE BOARD IF THERE ARE CONFLICTS AS TO WHETHER AN EMPLOYEE WHO APPLIES FOR BENEFITS IS, IN FACT, OFF WORK BECAUSE OF UNEMPLOYMENT OR SICKNESS.

None
None


No

1
IC Title Form No. Form Name
RAILROAD VERIFICATION OF CLAIMED UNEMPLOYMENT OR SICKNESS ID-4K, ID-4L

  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 20,200 20,200 0 0 0 0
Annual Time Burden (Hours) 786 786 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.
04/04/1989


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