RUIA Investigations and Continuing Entitlement

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form ID-4F Form Letter; Advising of Ineligibility for RUIA Benefits	Form and Instruction	Modified	Available
Form ID-20-4 Form Letter; Advising that Normal Sickness Benefits are About to Be Exhausted/Non-Entitlement	Form and Instruction	Modified	Available
Form ID-20-2 Form Letter; Advising that Normal Sickness Benefits Are About To Be Exhausted	Form and Instruction	Modified	Available
Form ID-20-1 Form Letter; Advising That Normal Unemployment Benefits Are About to Be Exhausted	Form and Instruction	Modified	Available
Form ID-4Y Form Letter; Advising of Ineligibility for Sickness Benefits	Form and Instruction	Modified	Available
Form ID-4X Form Letter; Advising of Service/Earnings Requirements for Sickness Benefits	Form and Instruction	Modified	Available
Form ID-4U Form Letter; Advising of Service and Earnings Requirements for RUIA Benefits	Form and Instruction	Modified	Available
Form UI-44 Claim for Credit for Military Service	Form and Instruction	Modified	Available
Form UI-23 Claimant's Statement of Service for Railroad Unemployment Insurance Benefits	Form and Instruction	Modified	Available
Form UI-9 Applicant's Statement of Employment and Wages	Form	Modified	Available
Form UI-48 Statement Regarding Benefit Claim for Days Worked	Form and Instruction	Modified	Repair queued
Form ID-5I Form Letter; Letter to Non-Railroad Employers	Form and Instruction	Modified	Available
Form ID-49R Form Letter; Letter to Railroad Employer for Payroll Information	Form and Instruction	Modified	Available
Form ID-5R (SUP) Report of Employees Paid RUIA Benefits for Every Day in Month Reported as Month of Creditable Service	Form	Modified	Available
Form ID-5I Form Letter; Letter to Non-Railroad Employers	Form and Instruction	Modified	Available
3220-0025.doc	Supporting Statement A	Uploaded 2010-07-27	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Form Letter; Advising of Ineligibility for RUIA Benefits
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Form Letter; Advising that Normal Sickness Benefits are About to Be Exhausted/Non-Entitlement
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Form Letter; Advising that Normal Sickness Benefits Are About To Be Exhausted
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Form Letter; Advising That Normal Unemployment Benefits Are About to Be Exhausted
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Form Letter; Advising of Ineligibility for Sickness Benefits
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Form Letter; Advising of Service/Earnings Requirements for Sickness Benefits
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Form Letter; Advising of Service and Earnings Requirements for RUIA Benefits
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Claim for Credit for Military Service
33830	RUIA Continuing Entitlement	Form and Instruction	Modified	Claimant's Statement of Service for Railroad Unemployment Insurance Benefits
33830	RUIA Continuing Entitlement	Form	Modified	Applicant's Statement of Employment and Wages
179869	Statement Regarding Benefit Claim for Days Worked	Form and Instruction	Modified	Statement Regarding Benefit Claim for Days Worked
179868	RUIA Investigations (state, local, tribal governments)	Form and Instruction	Modified	Form Letter; Letter to Non-Railroad Employers
179808	RUIA Investigations (private sector respondent)	Form and Instruction	Modified	Form Letter; Letter to Railroad Employer for Payroll Information
179808	RUIA Investigations (private sector respondent)	Form	Modified	Report of Employees Paid RUIA Benefits for Every Day in Month Reported as Month of Creditable Service
179808	RUIA Investigations (private sector respondent)	Form and Instruction	Modified	Form Letter; Letter to Non-Railroad Employers

ICR Details

OMB Control No: 3220-0025	ICR Reference No: 201006-3220-002
Status: Historical Active	Previous ICR Reference No: 200702-3220-001
Agency/Subagency: RRB	Agency Tracking No:
Title: RUIA Investigations and Continuing Entitlement
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/27/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/27/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2013	36 Months From Approved	08/31/2010
Responses	10,700	0	7,905
Time Burden (Hours)	2,512	0	1,622
Cost Burden (Dollars)	0	0	0

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Abstract: The information collection has two purposes. When RRB records that railroad service and/or compensation is insufficient to qualify a claimant for unemployment or sickness benefits, the RRB obtains information needed to reconcile the compensation and/or service on record with that claimed by the employee. Other forms in the collection allow the RRB to determine whether unemployment or sickness benefits were improperly obtained.

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Authorizing Statute(s): US Code: 45 USC 362 Name of Law: Railroad Unemployment Insurance Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 16874	04/02/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 44030	07/27/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
RUIA Continuing Entitlement	ID-4F, ID-4X, ID-20-1, ID-20-4, ID-20-2, UI-9, UI-23, UI-44, ID-4Y, ID-4U	Applicant's Statement of Employment and Wages ,   Claimant's Statement of Service for Railroad Unemployment Insurance Benefits ,   Claim for Credit for Military Service ,   Form Letter; Advising of Service and Earnings Requirements for RUIA Benefits ,   Form Letter; Advising of Service/Earnings Requirements for Sickness Benefits ,   Form Letter; Advising of Ineligibility for Sickness Benefits ,   Form Letter; Advising That Normal Unemployment Benefits Are About to Be Exhausted ,   Form Letter; Advising that Normal Sickness Benefits Are About To Be Exhausted ,   Form Letter; Advising that Normal Sickness Benefits are About to Be Exhausted/Non-Entitlement ,   Form Letter; Advising of Ineligibility for RUIA Benefits
RUIA Investigations (private sector respondent)	ID-5I, ID-49R, ID-5R (SUP)	Form Letter; Letter to Non-Railroad Employers ,   Report of Employees Paid RUIA Benefits for Every Day in Month Reported as Month of Creditable Service ,   Form Letter; Letter to Railroad Employer for Payroll Information
RUIA Investigations (state, local, tribal governments)	ID-5I	Form Letter; Letter to Non-Railroad Employers
Statement Regarding Benefit Claim for Days Worked	UI-48	Statement Regarding Benefit Claim for Days Worked

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ICR Summary of Burden

table that charts list of burden

	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	10,700	7,905	0	0	2,795	0
Annual Time Burden (Hours)	2,512	1,622	0	0	890	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/27/2010

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