Evidence of Marital Relationship - Living with Requirements

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0021 can be found here:

Documents and Forms

Document Name Document Type
Form G-124 Evidence of Marital Relationship - Living with Requirements Form
G-124 Statement of Marital Relationship Form G-124 (current).pdf Form
G-124A Statement Regarding Marriage Form G-124a (current).pdf Form
G-237 Statement Regarding Marital Status Form G-237 (current).pdf Form and Instruction
G-238A Statement Regarding Divorce or Annulment Form G-238a (current).pdf Form
G-238 Statement of Residence Form G-238 (current).pdf Form
Form G-242 (current).pdf Notice of Information Needed in Claim under Railroad Retirement Act IC Document
Form RL-26F (current).pdf RL-26, Transmittal Letter, Instruction Sheet IC Document
Form RL-57A-F (current).pdf RL-57A-F, Transmittal letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Evidence of Marital Relationship - Living with Requirements	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 219.3

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	G-124	Statement of Marital Relationship	Form G-124 (current).pdf	No	Paper Only
Form	G-124A	Statement Regarding Marriage	Form G-124a (current).pdf	No	Paper Only
Form and Instruction	G-237	Statement Regarding Marital Status	Form G-237 (current).pdf	No	Paper Only
Form	G-238A	Statement Regarding Divorce or Annulment	Form G-238a (current).pdf	No	Paper Only
Form	G-238	Statement of Residence	Form G-238 (current).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: 1,100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,100	1,100
Annual IC Time Burden (Hours)	196	196
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Notice of Information Needed in Claim under Railroad Retirement Act	Form G-242 (current).pdf	12/17/2008
RL-26, Transmittal Letter, Instruction Sheet	Form RL-26F (current).pdf	12/17/2008
RL-57A-F, Transmittal letter	Form RL-57A-F (current).pdf	12/17/2008

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