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Form RRB Form G-204 RRB Form G-204 Verification of Worker's Compensation/Public Disability
Application for Employee Annuity Under the Railroad Retirement Act
Form G-204 (11-02)
Application for Employee Annuity Under the Railroad Retirement Act
OMB: 3220-0002
OMB.report
RRB
OMB 3220-0002
ICR 200704-3220-002
IC 178327
Form RRB Form G-204 RRB Form G-204 Verification of Worker's Compensation/Public Disability
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3220-0002 can be found here:
2020-12-10 - Revision of a currently approved collection
2017-11-22 - Revision of a currently approved collection
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File Modified
2006-11-14
File Created
2006-11-14
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