Information Collection

Railroad Separation Allowance or Severance Pay Report

IC 33976 under ICR 200709-3220-002 · OMB 3220-0173.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0173 can be found here:

Documents and Forms

Document Name Document Type
Form BA-9 (07-03) Railroad Separation Allowance or Severance Pay Report Form and Instruction
BA-9 (07-03) Report of Separation Allowance or Severance Pay Form BA-9 (07-03)(current).pdf www.rrb.gov/pdf/AandT/ba9.pdf Form and Instruction
BA-9 (proposed) Report of Separation Allowance or Severance Pay Form BA-9 (proposed).pdf Form and Instruction
BA-9 (electronic e Report of Separation Allowance (file format/electronic e BA-9 instructions (Electronic equivalent) .pdf Form and Instruction
BA-9 (secure E-mai Report of Separation Allowance or Severance Pay Report Proposed Program Letter BA-9 (secure E-mail and FTP).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Railroad Separation Allowance or Severance Pay Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 209.14

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BA-9 (07-03)	Report of Separation Allowance or Severance Pay	Form BA-9 (07-03)(current).pdf	http://www.rrb.gov/pdf/AandT/ba9.pdf	Yes	No	Fillable Printable
Form and Instruction	BA-9 (proposed)	Report of Separation Allowance or Severance Pay	Form BA-9 (proposed).pdf		Yes	No	Fillable Printable
Form and Instruction	BA-9 (electronic equivalents)(proposed)	Report of Separation Allowance (file format/electronic equivalent)	BA-9 instructions (Electronic equivalent) .pdf		Yes	No	Fillable Fileable
Form and Instruction	BA-9 (secure E-mail - File Transfer Protocol)	Report of Separation Allowance or Severance Pay Report	Proposed Program Letter BA-9 (secure E-mail and FTP).pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: RRB-5; Master File of Railroad Employee's Creditable Compensation	FR Citation: 40 FR 36269

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 35 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	360	-1,670	2,030
Annual IC Time Burden (Hours)	457	-2,080	2,537
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.