Information Collection

Request for Verification of Last Date Carried on Payroll

IC 45673 under ICR 201301-3220-002 · OMB 3220-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0005 can be found here:

Documents and Forms

Document Name Document Type
Form G-88A.1 (02-05) Request for Verification of Last Date Carried on Payroll Form
G-88A.1 (02-05) Request for Verification of Date Last Worked Form G-88A.1.pdf www.rrb.gov/pdf/g88a.1.pdf Form
G-88a.1 (proposed) Request for Verification of Date Last Worked Form G-88A1(proposed).pdf Form
G-88a.1 (Internet) Notice of Retirement and Verification of Date Last Worke Form G-88A1 (Internet) proposed.pdf secure.rrb.gov/ERSNet/login.aspx Form and Instruction
Description of Proposed G-88A-1 Screens.pdf G-88a.1 (Internet) proposed screens description IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Verification of Last Date Carried on Payroll	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 209.7

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G-88A.1 (02-05)	Request for Verification of Date Last Worked	Form G-88A.1.pdf	http://www.rrb.gov/pdf/g88a.1.pdf	Yes	No	Printable Only
Form	G-88a.1 (proposed)	Request for Verification of Date Last Worked	Form G-88A1(proposed).pdf		Yes	No	Printable Only
Form and Instruction	G-88a.1 (Internet) proposed	Notice of Retirement and Verification of Date Last Worked	Form G-88A1 (Internet) proposed.pdf	https://secure.rrb.gov/ERSNet/login.aspx	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: RRB 22 - Railroad Retirement Survivor Pensioner and Benefit System	FR Citation: 75 FR 43727

Number of Respondents: 579	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	504	0	504
Annual IC Time Burden (Hours)	63	-15	78
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
G-88a.1 (Internet) proposed screens description	Description of Proposed G-88A-1 Screens.pdf	02/04/2013

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