Application for Survivor Insurance Annuities

Application for Survivor Insurance Annuities

OMB: 3220-0030

IC ID: 33834

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form
Form
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form
Form
Form
Form
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Application for Survivor Insurance Annuities
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 219 20 CFR 216 20 CFR 217 20 CFR 218

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction AA-19 (proposed) Application for Child's Annuity Form AA-19 (Proposed).pdf No   Paper Only
Form and Instruction AA-20 (proposed) Application for Parent's Annuity Form AA-20 (Proposed).pdf No   Paper Only
Form AA-17cert (proposed)(All Possible) Application Summary and Certification Form AA-17cert Proposed (All Possible).pdf Yes Yes Printable Only
Form AA-17cert proposed (Completed) Application Summary and Certification Form AA-17cert Proposed (Completed).pdf Yes Yes Printable Only
Form AA-17sum proposed (all possible) Application Summary Form AA-17sum Proposed (All Possible).pdf Yes Yes Printable Only
Form AA-17sum proposed (completed) Application Summary Form AA-17sum Proposed (Completed).pdf Yes Yes Printable Only
Form and Instruction AA-19 (08-09) Application for Child's Annuity Form AA-19 (08-09).pdf No   Paper Only
Form and Instruction AA-19a (10-07) Application for Determination of Child's Disability Form AA-19a (10-07).pdf No   Paper Only
Form and Instruction AA-20 (08-09) Applicationfor Parent's Annuity Form AA-20 (08-09).pdf No   Paper Only
Form AA-17cert (09-06)(all possible) Application Summary and Certification AA-17cert(Allpossible)(09-06).pdf Yes Yes Printable Only
Form AA-17cert (09-06) Application Summary and Certification Form AA-17cert (09-06) (Completed).pdf Yes Yes Printable Only
Form and Instruction AA-17 (Proposed) Application for Widow(ers) Annuity Form AA-17 (Proposed).pdf No   Paper Only
Form and Instruction AA-18 (proposed) Application for Mother/Father's and Childs Annuity Form AA-18 (Proposed).pdf No   Paper Only
Form and Instruction AA-18 (08-09) Applications for Mother's/Father's and Child's Annuity Form AA-18 (08-09).pdf No   Paper Only
Form and Instruction AA-17 (08-09) Application for Widow(ers) Annuity Form AA-17 (08-09).pdf No   Paper Only
Form and Instruction AA-17b (10-07) Application for Determination of Widow(ers) Disability Form AA-17b (10-07).pdf No   Paper Only

Income Security General Retirement and Disability

RRB-22, Railroad Retirement, Survivor, and Pensioner Benefit System   75 FR 43727

3,722 0
   
Individuals or Households
 
   81 %

  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 3,722 0 0 0 0 3,722
Annual IC Time Burden (Hours) 1,494 0 -35 0 0 1,529
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
RB-3 Booklet; Furnishing Evidence to Support Your Claim RB-3 (11-08).pdf 07/16/2009
RB-17 Booklet, Survivor Annuities Form RB-17 (07-04).pdf 07/01/2004
RB-17b Booklet; Widow(ers) Disability Benefits RB-17b (03-09).pdf 07/16/2009
RB-19A Booklet; Child's Disability Benefits RB-19a (5-99).pdf 05/03/1999
AA-17rec; Receipt for Claim Form AA-17rec (11-08).pdf 07/20/2009
Transmittal Letter for self-administered retirement applications Form RL-1S (04-07).pdf 11/29/2012
RB-17 page revision RB-17 Page Revision.pdf 11/29/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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