Survivor Questinnaire

ICR 200604-3220-001

OMB: 3220-0032

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
33842 Migrated
ICR Details
3220-0032 200604-3220-001
Historical Active 200304-3220-001
RRB
Survivor Questinnaire
Extension without change of a currently approved collection   No
Regular
Approved without change 06/06/2006
Retrieve Notice of Action (NOA) 04/17/2006
  Inventory as of this Action Requested Previously Approved
06/30/2009 06/30/2009 06/30/2006
8,000 0 8,000
1,391 0 1,391
0 0 0

Under Section 6 of the Railroad Retirement Act, benefits are payable to the survivors or the estates of deceased railroad employees. The collection obtains information about the survivor if any payment of burial expenses and administration of estate when unknown to the Railraod Retirement Board. The information is used to determine whether and to whom benefits are payable.

None
None


No

1
IC Title Form No. Form Name
Survivor Questinnaire RL-94-F

  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 8,000 8,000 0 0 0 0
Annual Time Burden (Hours) 1,391 1,391 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.
04/17/2006


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