Application and Claim for RUIA Benefits Due at Death

Application and Claim for RUIA Benefits Due at Death

OMB: 3220-0055

IC ID: 33869

Information Collection (IC) Details

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Application and Claim for RUIA Benefits Due at Death
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 355.5 20 CFR 325.5

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction UI-63 (02-09) Application for Benefits Due But Unpaid at Death Form UI-63 (02-09).pdf No   Paper Only

Income Security Unemployment Compensation

RRB-21; Railroad Unemployment and Sickness Insurance Benefit System  75 FR 43725

25 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 25 0 0 -175 0 200
Annual IC Time Burden (Hours) 3 0 0 -20 0 23
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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