Railroad Unemployment Insurance Act Applications

ICR 200101-3220-001

OMB: 3220-0039

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
33856 Migrated
ICR Details
3220-0039 200101-3220-001
Historical Active 199802-3220-001
RRB
Railroad Unemployment Insurance Act Applications
Revision of a currently approved collection   No
Regular
Approved without change 02/08/2001
Retrieve Notice of Action (NOA) 01/02/2001
  Inventory as of this Action Requested Previously Approved
02/29/2004 02/29/2004 04/30/2001
271,900 0 270,900
27,971 0 27,921
0 0 0

Under Section 2 of the Railroad Unemployment Insurance Act, unemployment and sickness benefits are provided for qualified railroad employees. The collection obtains information needed to determine eligibility for and amount of such benefits from railroad employees and physicians. Also collects information from individuals acting on behalf of sick or injured employees and supplemental information from railroad employers regarding settlement of injuries or accidents for which sickness benefits were paid.

None
None


No

1
IC Title Form No. Form Name
Railroad Unemployment Insurance Act Applications SI-1A, SI-1B, SI-3, SI-7, SI-8, ID-7H, ID-11A, ID-11B

  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 271,900 270,900 0 0 1,000 0
Annual Time Burden (Hours) 27,971 27,921 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.
01/02/2001


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