Information Collection

Employee's Certification

IC 33938 under ICR 200812-3220-002 · OMB 3220-0140.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0140 can be found here:

Documents and Forms

Document Name Document Type
Form G-346 (06-08) Employee's Certification Form
G-346 (06-08) Employee's Certification Form G-346 (06-08).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Employee's Certification	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 219.30 - 219.35

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G-346 (06-08)	Employee's Certification	Form G-346 (06-08).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records
Title: RRB-22, Railroad Retirement, Survivor and Pensioner Benefit System	FR Citation: 72 FR 73516

Number of Respondents: 6,900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,900	-660	7,560
Annual IC Time Burden (Hours)	575	-55	630
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.