G-88a.1 (Internet) Notice of Retirement and Verification of Date Last Worke

PROPOSED
G-88A.1 (INTERNET)
Screen 1

Screen 2

ERS Login Screen

Screen 3

ERS Menu Screen (New Items)

Form G-88A.1 will
appear here for users.

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US Railroad Retirement Board
Form G-88A.1 (XX-XX)

Form Approved
OMB No. 3220-0005

Request for Verification of Date Last Worked
Employer BA No: 1524

Retirements In: April 2012

Request Date: 05/02/2012

Below is a listing of your employees who have recently filed for Railroad Retirement Act (RRA) age and service or disability annuities. The dates
shown on the listing were provided by the employees on their annuity applications.
Submit any corrections by of the month following the date of this request.
Instructions
1. Verify that the Date Last Worked for your railroad and, if applicable, the last day of any Pay for Time Lost shown for each of the employees
listed are correct. It is important that these dates are correct because they affect the date employee RRA annuities can begin.
2. Verify that the Date Rights Relinquished to return to railroad employment shown for each employee who filed for an annuity based on age and
service is correct.
3. If all the dates shown on the listing are correct, no further action is necessary. Click on Exit to ERS Menu to exit this screen and return to the
ERS Menu.
4. If any of the dates shown for an employee are not correct, click on the employee’s social security number to go to the Reply screen to provide
the correct date.
Note: You can sort the listing in Payroll ID order by clicking Payroll ID. You can also delete any or all records from the listing after you have
verified the dates and/or submitted corrected dates. To delete records individually, check the box to the left of the record you wish to delete then
click on Delete Marked Items. To delete all the records at once, click on Select All, which checks all the boxes, then Delete Marked Items.
Select All

SSN

Delete Marked Items

Payroll Name

Payroll ID

Exit to ERS Menu

Job Title

Dept or Div
OPERATING

Location
BUFFALO NY

Date
Last
Worked
(DLW)

Last Day
of Pay for
Time Lost,
If Later
Date Rights
Than DLW Relinquished

*****0011 JOHN H HENRY

9907530129 SWITCHMAN

04/20/2012

04/20/2012

*****1111 RAIL R EMPLOYEE

0987654321 LOCOMOTIVE ENGI TRANSPORTATION NEWPORT NEWS VA

04/30/2012

04/30/2012

*****2222 JOHN Q SMITH

2315647891 CONDUCTOR

04/13/2012

04/13/2012

TRANSPORTATION JACKSONVILLE FL

*****3333 EDWARD T JOHNSO 4568971320 EQUIPMENT REPAI M OF W

YOUNGSTOWN OH

04/30/2012

04/30/2012

*****4444 ROBERT B COLEMA 5641943510 BOILERMAKER

HUNTINGTON WV

04/30/2012

04/30/2012

JACKSONVILLE FL

10/31/2011

N CHARLESTON SC

*****5555 SUSAN M WILLIAM

MECHANICAL

3479561919 SR OPER ANALYST PAYROLL

*****6666 LAWRENCE S RYAN 8897796543 CARMAN/CAR INSP MECHANICAL

04/30/2012

04/30/2012

*****7777 AL W HARRIS

7845120321 BRAKEMAN

TRANSPORTATION CUMBERLAND MD

04/30/2012

04/30/2012

*****8888 WILLIAM PETERSO

1346798528 TRACK FOREMAN

ENGINEERING

ATLANTA GA

03/30/2012

04/30/2012

SIGNALS

LIVONIA MI

12/30/2011

*****9999 ARTHUR D NELSON 6031547854 SIGNAL MAINTAIN

Paperwork Reduction Act Notice

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US Railroad Retirement Board
Form G-88A.1 (XX-XX)

Form Approved
OMB No. 3220-0005

Request for Verification of Date Last Worked – Reply
Instructions
For your convenience, we have carried over the date(s) from the listing into Item 2a, below.
Enter the correct date(s) in Item b, Date In Employer Records.
Explain the date correction in Item 6, Remarks.
Click Submit to submit the correction and return to the Listing screen.
Other Actions
Click the Reset Record button to clear any entries you have made.
Click the Exit/No Action button to return to the Listing screen without making or saving any entries.
1. Social Security No:
*****9999

2. Payroll Name
ARTHUR D NELSON

3. Date Last Worked

a.

Date Provided
By Employee

b.

Date In
Employer Records

12/30/2011

4. Last Day of Pay for Time Lost, If Later Than Date Last Worked
5. Date Rights Relinquished, If Applicable

6. Remarks –
Explain Date
Correction

Certification: I understand that civil and criminal penalties can be imposed against me for false or fraudulent statements or for withholding
information to misrepresent a fact material to determining a right to payment under the Railroad Retirement Act. I certify that, to the best of
my knowledge, the information which I have given is true, complete, and correct.
Submit

Reset Record

Exit/No Action

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Paperwork Reduction Act Notice
The information to be verified on the screen listing is needed to determine your
employee’s eligibility for a retirement annuity under Section 2 of the Railroad Retirement
Act (RRA)(45 USC 231A). Furnishing this information is required by law (Section 7(b)(6))
of the RRA (45 USC 231f(b)(6)).
We estimate it takes an average of 4-16 minutes per response for each screen listing,
including the time needed for reviewing the instructions, getting the needed data, and
reviewing the listing. Federal agencies may not conduct or sponsor, and respondents
are not required to respond to, a collection of information unless it displays a valid OMB
number. If you wish, send comments regarding the accuracy of our estimate or any other
aspect of this form, including suggestions for reducing the completion time, to Chief of
Information Resources Management, Railroad Retirement Board, 844 N. Rush Street,
Chicago, IL 60611-2092.