Form G-88 Certification of Termination of Service and Relinquishme

United States of America
Railroad Retirement Board

Certification of
Termination of Service
and Relinquishment of Rights
Applicant's Name and Address

Form Approved
OMB NO. 3220-0016
RRB Claim Number

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For RRB Use Only
Application filed on date:
Form G-88A.2 was mailed to:

The Ra~lroadRetirement Board (RRB) is authorized to
collect the following information under section 7(b)(6)
of the Railroad Retirement Act (RRA). This
information is needed to determine your eligibility to
an annuity under the RRA and the amount of that
annuity. You are not required to furnish this
information, but if you do not, we may not be able to
pay you any benefits.
We estimate this form takes an average of 6 minutes
to complete, including the time for reviewing the
instructions, getting the needed data, and reviewing
the completed form. Federal agencies may not
conduct or sponsor, and respondents are not required
to respond to, a collection of information unless it

A railroad employer is any company or labor
organization covered by the RRA. Applicants for an
annuity under the RRA must stop all work for pay for a
railroad employer before an annuity can be paid.
In addition, relinquishment of rights to return to any
railroad employment is required for all age and
service employee applicants, spouse applicants
and divorced spouse applicants.

Your Last Pre-Retirement Nonrailroad Employer (LPE)
is defined as any nonrailroad individual, company, or
institution for whom you are working on your annuity
beginning date (ABD) or for whom you stopped
working in order to receive an annuity. The
nonrailroad employer is always your LPE if you are
working in nonrailroad employment on your ABD, or, if
you have stopped working and you still hold rights to
return to service of the nonrailroad employer on your
ABD.
When you were working for one or more individuals,
companies, or institutions within the 6 months
immediately preceding the date your annuity begins,
all such employers are presumed to be your LPE.
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displays a valid OMB number. If you wish, send
comments regarding the accuracy of our estimate or
any other aspect of this form, including suggestions
for reducing completion time, to Chief of Information
Resources Management, Railroad Retirement
Board, 844 N. Rush St, Chicago, Illinois 606112092.

If you need help in completing this form, contact
the nearest office of the RRB. If you need to
personally visit one of our field offices, you are
urged to call for an appointment. You will not be
refused service if you do not have an appointment,
but the RRB representatives can serve you better
when an appointment is made.

Disability applicants under Full Retirement Age
(FRA) do not need to give up rights to return to
railroad service in order to receive an annuity.
However, relinquishment of rights is automatic on
the earliest of the date the applicant attains FRA or
becomes entitled to a supplemental annuity or the
spouse files for a spouse annuity.

There are a few exceptions. Types of work that are
not considered to be LPE are: military service, jury
duty, mail handling by contract with the U.S. Postal
Service, volunteer work, work for which you only
receive payment of expenses, work as a member
(owner) of a Limited Liability Corporation (LLC), or
self-employment.
Your ABD is not affected by LPE. You are not
required to relinquish rights or stop working for your
LPE to receive annuity payments. However,
reductions for LPE earnings on or after your ABD
apply regardless of your age.

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Form G-88 (0 1-05) (Destroy Prior Editions)

page explains when you mist stopwork and
service of an employer.
Complete the sections below marked with an "X."
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rights

up

to return t i the

Railroad Employment

,

Complete ltems 1-4 for any employer in the railroad industry for whom you last worked. If you had joint service,
or worked for another railroad employer within the last 18 months, show the answers to ltems 1-4 about the other
employer in Section C, Remarks.
1. Last railroad employer
1 2. Last date worked for pay

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1
Month Day
Year

3. Do you hold seniority or other rights to return to any employer(s) in
the railroad industry?

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Yes - Enter employer name(s)

4. Date all rights to return to employer
service relinquished.

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No

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Employer Name(s)

1

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1
--Day

Month

Year

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7
Employment Outside the Railroad Industry

If you had any n
o
n
r
would be considered to be Last Pre-Retirement IVonrailroad Employment, complete ltems 5a-6d. Use Section
C, Remarks if more space is needed.
6. a. Next to last nonrailroad employer's name
5. a. Last nonrailroad employer's name
b. Address

c.

b. Address

Date work began

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1
---

Month Day Year

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d. Date work ended

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1
---

Month Day Year

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Remarks

7. If you need m

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c. Date work began

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1--

Month Day Year

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o

r

r

I d.

Date work ended

1

1--

Month Day Year

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e

l

m

t

8. 1 w ~ lpromptly
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notify the Railroad Retirement Board if I return to the service of any railroad employer or I return
to work for the individual, company, or institution named in Section B above.
Knowing that anyone making a false statement or representation of a material fact for use in determining a
right to payment under the Railroad Retirement Act commits a crime punishable under Federal Law, I certify
that the information given above is true.
Sianature

Date
~

~-

9. If this certification is signed by & a r k ~ ( " in
~ )Item 8, two witnesses who know the person signing must sign
below, giving their full addresses and daytime telephone numbers.
la. Signature of Witness
b. Signature of Witness

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Address (Number and Street)

Address (Number and Street)

City, State, ZIP Code

City, State, ZIP Code

Daytime Telephone Number
)

Daytime Telephone Number
(

Form G-88 (0 1-05) (Destroy Prior Editions)

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