Employer Service and Compensation Reports

ICR 200108-3220-001

OMB: 3220-0070

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
33874 Migrated
ICR Details
3220-0070 200108-3220-001
Historical Active 199807-3220-003
RRB
Employer Service and Compensation Reports
Revision of a currently approved collection   No
Regular
Approved without change 10/02/2001
Retrieve Notice of Action (NOA) 08/03/2001
  Inventory as of this Action Requested Previously Approved
10/31/2004 10/31/2004 10/31/2001
3,000 0 4,500
400 0 600
0 0 0

The reports obtain the employee's service and compensation for a period subsequent to those already on file and the employee's base year compensation. The information is used to determine the entitlement to and the amount of benefits payable.

None
None


No

1
IC Title Form No. Form Name
Employer Service and Compensation Reports UI-41, UI-41A

  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 3,000 4,500 0 0 -1,500 0
Annual Time Burden (Hours) 400 600 0 0 -200 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.
08/03/2001


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