Certification of Termination of Service and Relinquishment of Rights

ICR 200805-3220-001

OMB: 3220-0016

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2008-05-07
IC Document Collections
ICR Details
3220-0016 200805-3220-001
Historical Active 200503-3220-003
RRB
Certification of Termination of Service and Relinquishment of Rights
Revision of a currently approved collection   No
Regular
Approved without change 07/23/2008
Retrieve Notice of Action (NOA) 05/23/2008
  Inventory as of this Action Requested Previously Approved
07/31/2011 36 Months From Approved 07/31/2008
3,600 0 3,600
360 0 360
0 0 0

Under Section 2(e)(2) of the Railroad Retirement Act, the Railroad Retirement Board must have evidence than an annuitant for an age and service, spouse, or divorced spouse annuity has ceased railroad employment and relinquished their rights to return to the service of a railroad employer. The collection provides the means for obtaining this evidence.

US Code: 45 USC 231f(b)(6) Name of Law: Railroad Retirement Act
  
None

Not associated with rulemaking

  73 FR 10074 02/25/2008
73 FR 28538 05/16/2008
No

  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 3,600 3,600 0 0 0 0
Annual Time Burden (Hours) 360 360 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Charles Mierzwa 312-751-3363 [email protected]

  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.
05/23/2008


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