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Application for Spouse Annuity Under the Railroad Retirement Act
Application for Spouse Annuity Under the Railroad Retirement Act
OMB: 3220-0042
IC ID: 33861
OMB.report
RRB
OMB 3220-0042
ICR 200611-3220-001
IC 33861
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0042 can be found here:
2022-04-28 - Extension without change of a currently approved collection
2019-03-04 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form AA-3cert
Application for Spouse Annuity Under the Railroad Retirement Act
Form
AA-3 Application for Spouse/Divorced Spouse Annuity
AA-3 (05-04)(current).pdf
Form
AA-3 (proposed) Application for Spouse/Divorced Spouse Annuity
AA-3(proposed).pdf
Form
AA-3cert Application Summary and Certification
AA-3cert(07-02)current.pdf
Form
AA-3cert (proposed Application Summary and Certification
AA-3cert(proposed).pdf
Form
AA-7 (01-03).pdf
AA-7, Spouse/Divorced Application for Medicare
IC Document
G-208 (09-04).pdf
G-208, Public Service Pension Questionnaire
IC Document
G-19F (07-04).pdf
G-19F, Earnings Information Request
IC Document
RL-1 (07-03).pdf
RL-1
IC Document
RB-3 (08-04).pdf
RB-3
IC Document
RB-30 (06-04).pdf
RB-30
IC Document
RB-9 (05-04).pdf
RB-9
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Spouse Annuity Under the Railroad Retirement Act
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 216.50
20 CFR 218.11
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
AA-3cert
Application Summary and Certification
AA-3cert(07-02)current.pdf
Yes
Yes
Fillable Printable
Form
AA-3cert (proposed)
Application Summary and Certification
AA-3cert(proposed).pdf
Yes
Yes
Fillable Printable
Form
AA-3 (proposed)
Application for Spouse/Divorced Spouse Annuity
AA-3(proposed).pdf
No
Paper Only
Form
AA-3
Application for Spouse/Divorced Spouse Annuity
AA-3 (05-04)(current).pdf
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Survivor Compensation
Privacy Act System of Records
Title:
RRB-22, Railroad Retirement, Survivor and Pensioner Benefit System
FR Citation:
40 FR 36268
Number of Respondents:
8,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
99 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
8,500
0
0
0
0
8,500
Annual IC Time Burden (Hours)
4,297
0
0
0
0
4,297
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
RL-1
RL-1 (07-03).pdf
11/22/2006
RB-3
RB-3 (08-04).pdf
11/22/2006
RB-30
RB-30 (06-04).pdf
11/22/2006
RB-9
RB-9 (05-04).pdf
11/22/2006
AA-7, Spouse/Divorced Application for Medicare
AA-7 (01-03).pdf
12/04/2006
G-208, Public Service Pension Questionnaire
G-208 (09-04).pdf
12/04/2006
G-19F, Earnings Information Request
G-19F (07-04).pdf
12/04/2006
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.