G-88a.2 (Internet) Notice of Retirement and Request for Service Needed for

PROPOSED
G-88A.2 (INTERNET)
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ERS Login Screen

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ERS Menu (New Items)

Form G-88A.2 will
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US Railroad Retirement Board
Form G-88A.2 (XX-XX)

Form Approved
OMB N0. 3220-0005

Notice of Retirement and Request for Service Needed for Eligibility
The employee below filed an application for an annuity and has informed the Railroad Retirement Board that (s)he stopped
working on the date shown in Item 10 and, if applicable, relinquished employment rights on the date shown in Item 11.
Submit the requested information within 10 days of the release date. The employee cannot be awarded an annuity until we
receive this information.
Instructions
If the date shown in Item 10, Date Last Worked or Paid for Time Lost, is different from your records, enter the correct date in
Item 12, Date Last Worked or Paid for Time Lost on Your Records. Otherwise, leave Item 12 blank.
Always complete Item 13.
Click Submit after completing all the required items to submit the information to the RRB.
Other Actions
Click the Reset Record button to clear any entries you have made.
Click the Exit/No Action button to return to the new G-88A.2 list without making or saving any entries.
IMPORTANT NOTES: This employee’s service months and compensation must also be included on your Form BA-3, Annual
Report of Creditable Compensation. NOTIFY THE RRB IMMEDIATELY IF THE EMPLOYEE RETURNS TO COMPENSATED
SERVICE. If you have any questions, refer to the Employer Reporting Instructions or telephone the Quality Reporting Service
Center at (312) 751-4992.
1. Social Security No.

2. Name of Employee

3. BA No.

111-11-1111
4. Payroll Number

RAIL R EMPLOYEE
5. Job Title

1524
6. Work Location

123456789
7. Dept. or Div.

LOCOMOTIVE ENGI
8. RRB Filing Date

NEWPORT NEWS VA
9. Date Released

TRANSPORTATION
10. Date Last Worked or Paid for Time Lost

05/4/2012
11. Date Rights Relinquished

05/4/2012
12. Date Last Worked or Paid for Time
Lost in Your Records

04/30/2012
04/30/2012
13. In Item 13a, Current Year, check the boxes for the months the employee had service in the year shown in Item 10. If you are
submitting your response before your annual report for the prior year, check the boxes in Item 13b, Prior Year, for the months
the employee had service in the prior year. Do not report service months after the date in Item 11.
J
F
M
A
M
J
J
A
S
O
N
D
TOTAL MONTHS
a.

Current Year

b.

Prior Year

14. REMARKS

Paperwork Reduction Act Notice
Employer 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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ERS Menu (Completed Items)

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Paperwork Reduction Act Notice
The Railroad Retirement Board’s (RRB) authority for requesting this information
is Section 7(b)(6) of the Railroad Retirement Act (RRA) (45 U.S.C. 231f(b)(6)).
The information requested is used by the RRB to determine your employee’s
eligibility for a retirement annuity under Section 2 of the RRA (45 U.S.C. Sec.
231a).
We estimate it takes an average of 2.5 minutes per response, including the time
for reviewing the instructions, getting the needed data, and reviewing the
completed screen. 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 any 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.