Information Collection

Statements Of Claimed Railroad Service And Earnings

IC 157313 under ICR 199403-3220-001 · OMB 3220-0025.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0025 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	STATEMENTS OF CLAIMED RAILROAD SERVICE AND EARNINGS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	UI-9, UI-23,	No	No
Form	ID-4F, ID-4U	No	No
Form	ID-4X, ID-4Y	No	No
Form	ID-20-1	No	No
Form	ID-20-2	No	No
Form	ID-20-4	No	No
Form	ID-20-5	No	No
Form	ID-20-7	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,725	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,725	5,725
Annual IC Time Burden (Hours)	578	578
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.