Information Collection

Certification of Termination of Service and Relinquishment of Rights

IC 33819 under ICR 200805-3220-001 · OMB 3220-0016.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0016 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form G-88 Certification of Termination of Service and Relinquishment of Rights	Form
G-88 Certification of Termination of Service and Relinquishme Form G-88 (01-05).pdf	Form

IC Title:

Certification of Termination of Service and Relinquishment of Rights

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 216.24

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G-88	Certification of Termination of Service and Relinquishment of Rights	Form G-88 (01-05).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: RRB-22, Railroad Retirement, Survivor, and Pensioner Benefit System

FR Citation: 72 FR 73516

Number of Respondents: 3,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3,600	3,600
Annual IC Time Burden (Hours)	360	360
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.