Employer's Deemed Service Month Questionnaire

ICR 201211-3220-003

OMB: 3220-0156

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2009-07-17
Supporting Statement A
2012-11-19
IC Document Collections
ICR Details
3220-0156 201211-3220-003
Historical Active 200906-3220-003
RRB
Employer's Deemed Service Month Questionnaire
Revision of a currently approved collection   No
Regular
Approved without change 03/14/2013
Retrieve Notice of Action (NOA) 11/20/2012
  Inventory as of this Action Requested Previously Approved
03/31/2016 36 Months From Approved 03/31/2013
4,000 0 4,000
133 0 133
0 0 0

Under Section 3(i) of the Railroad Retirement Act, the Railroad Retirement Board may deem months of service in cases where an employee does not actually work in every month of the year. The collection obtains service and compensation information from railroad employers needed to determine if an employee may be credited with additional months of railroad service.

US Code: 45 USC 231(f) et.seq. Name of Law: Railroad Retirement Act
  
None

Not associated with rulemaking

  77 FR 51835 08/27/2012
77 FR 69666 11/20/2012
No

1
IC Title Form No. Form Name
Employer's Deemed Service Month Questionnaire GL-99 (11-09), GL-99 (proposed) Employer's Deemed Service Months Questionnaire ,   Employer's Deemed Service Month Questionnairre

  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 4,000 4,000 0 0 0 0
Annual Time Burden (Hours) 133 133 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
Yes
No
No
No
Uncollected
Charles Mierzwa 312-751-3363 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/20/2012


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