Information Collection

RUIA Continuing Entitlement

IC 33830 under ICR 201308-3220-002 · OMB 3220-0025.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0025 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form UI-9 (11-00) RUIA Continuing Entitlement	Form
UI-9 (11-00) Statement of Employment and Wages Form UI-9 (11-00).pdf	Form
UI-44 (11-00) Claim for Credit for Military Service Form UI-44 (11-00).pdf	Form and Instruction
ID-4U (05-13) Form Letter; Advising of Service and Earnings Requiremen Form ID-4U (05-13).pdf	Form and Instruction
ID-4X (05-13) Form Letter; Advising of Service/Earnings Requirements f Form ID-4X (05-13).pdf	Form and Instruction
Form ID-4 (05-13).pdf Form Letter ID-4; Requesting Additional Information on Wages and Service	IC Document
Form ID-4S-2 (05-13).pdf Form Letter ID-4-S-2; Advising of Service and Earnings Requirements for RUIA Benefits	IC Document
Form ID-4S-1 (05-13).pdf Form Letter ID-4-S-1, Advising of Service and Earnings Requirements for RUIA Benefits	IC Document
Form ID-32N (05-04).pdf Form Letter ID-32N; Establishing Extended Sickness Benefits and Data on Individual Service	IC Document

IC Title:

RUIA Continuing Entitlement

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 335 20 CFR 325 20 CFR 336

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	UI-9 (11-00)	Statement of Employment and Wages	Form UI-9 (11-00).pdf	No	Paper Only
Form and Instruction	UI-44 (11-00)	Claim for Credit for Military Service	Form UI-44 (11-00).pdf	No	Paper Only
Form and Instruction	ID-4U (05-13)	Form Letter; Advising of Service and Earnings Requirements for RUIA Benefits	Form ID-4U (05-13).pdf	No	Paper Only
Form and Instruction	ID-4X (05-13)	Form Letter; Advising of Service/Earnings Requirements for Sickness Benefits	Form ID-4X (05-13).pdf	No	Paper Only

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records

Title: RRB-21, Railroad Unemployment and Sickness Insurance Benefit System

FR Citation: 75 FR 43725

Number of Respondents: 139

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	139	-251	390
Annual IC Time Burden (Hours)	12	-23	35
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Form Letter ID-4; Requesting Additional Information on Wages and Service	Form ID-4 (05-13).pdf	08/28/2013
Form Letter ID-4-S-2; Advising of Service and Earnings Requirements for RUIA Benefits	Form ID-4S-2 (05-13).pdf	08/28/2013
Form Letter ID-4-S-1, Advising of Service and Earnings Requirements for RUIA Benefits	Form ID-4S-1 (05-13).pdf	08/28/2013
Form Letter ID-32N; Establishing Extended Sickness Benefits and Data on Individual Service	Form ID-32N (05-04).pdf	08/28/2013

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