Application for Spouse Annuity Under the Railroad Retirement Act

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0042 can be found here:

Documents and Forms

Document Name Document Type
Form AA-3 (current )(05 Application for Spouse Annuity Under the Railroad Retirement Act Form
AA-3 (current )(05 Application for Spouse/Divorced Spouse Annuity Form AA-3 (05-10).pdf Form
AA-3 (proposed) Application for Spouse/Divorced Spouse Annuity Form AA-3 Proposed.pdf Form
AA-3cert Application Summary and Certification Form AA-3cert (09-07).pdf Form
AA-3cert (all poss Application Summary and Certification Form AA-3cert (09-07) all possible.pdf Form and Instruction
AA-3cert (proposed Application Summary and Certfication Form AA-3cert Proposed (All Possible).pdf Form
AA-3cert (proposed Application Summary and Certification Form AA-3cert Proposed (Completed).pdf Form
AA-3sum (proposed) Application Summary Form AA-3sum Proposed (All Possible).pdf Form
AA-3sum(proposed)( Application Summary Form AA-3sum Proposed (Completed).pdf Form
Form RL-1 (04-07).pdf RL-1 IC Document
Form RB-3 (11-08).pdf RB-3, Furnishing Evidence To Support Your Claim IC Document
Form RB-30 (05-09).pdf RB-30, Spouse/Divorced Spouse Annuity IC Document
Form RB-09 (03-09).pdf RB-9, Employee and Spouse Annuities - Events That Must Be Reported IC Document
Form AA-7 (01-12).pdf AA-7, Spouse/Divorced Application for Medicare IC Document
Form G-208 (04-11).pdf G-208, Public Service Pension Questionnaire IC Document
Form G-19F (10-07).pdf G-19F, Earnings Information Request IC Document
RB-30 Page Revision.pdf RB-30 (page revision) proposed IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Spouse Annuity Under the Railroad Retirement Act	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 218.11 20 CFR 216.50

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AA-3 (current )(05-10)	Application for Spouse/Divorced Spouse Annuity	Form AA-3 (05-10).pdf	Yes	No	Paper Only
Form	AA-3 (proposed)	Application for Spouse/Divorced Spouse Annuity	Form AA-3 Proposed.pdf	No		Paper Only
Form	AA-3cert	Application Summary and Certification	Form AA-3cert (09-07).pdf	Yes	Yes	Fillable Printable
Form and Instruction	AA-3cert (all possible)	Application Summary and Certification	Form AA-3cert (09-07) all possible.pdf	Yes	Yes	Fillable Printable
Form	AA-3cert (proposed) (all possible)	Application Summary and Certfication	Form AA-3cert Proposed (All Possible).pdf	Yes	Yes	Fillable Printable
Form	AA-3cert (proposed) (completed)	Application Summary and Certification	Form AA-3cert Proposed (Completed).pdf	Yes	Yes	Fillable Printable
Form	AA-3sum (proposed)(all possible)	Application Summary	Form AA-3sum Proposed (All Possible).pdf	Yes	Yes	Fillable Printable
Form	AA-3sum(proposed)(completed)	Application Summary	Form AA-3sum Proposed (Completed).pdf	Yes	Yes	Fillable Printable

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: 75 FR 43727

Number of Respondents: 11,050	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11,050	0	11,050
Annual IC Time Burden (Hours)	5,324	-318	5,642
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
RL-1	Form RL-1 (04-07).pdf	02/25/2010
RB-3, Furnishing Evidence To Support Your Claim	Form RB-3 (11-08).pdf	02/25/2010
RB-30, Spouse/Divorced Spouse Annuity	Form RB-30 (05-09).pdf	02/25/2010
RB-9, Employee and Spouse Annuities - Events That Must Be Reported	Form RB-09 (03-09).pdf	02/25/2010
AA-7, Spouse/Divorced Application for Medicare	Form AA-7 (01-12).pdf	12/05/2012
G-208, Public Service Pension Questionnaire	Form G-208 (04-11).pdf	12/05/2012
G-19F, Earnings Information Request	Form G-19F (10-07).pdf	02/25/2010
RB-30 (page revision) proposed	RB-30 Page Revision.pdf	12/05/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.