3220-0179

3220-0179.doc

Annual Earnings Questionnaire for Annuitants in Last Pre-Retirement Non-Railroad Employment

OMB: 3220-0179

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OMB NO. 3220-0179


Justification

Annual Earnings Questionnaire for Annuitants

in Last Pre-Retirement Non-Railroad Employment

RRB Form G-19L


  1. Circumstances of information collection - Under section 2(e)(3) of the Railroad Retirement Act (RRA), an annuity is not payable for any month in which the beneficiary works for a railroad. In addition, it is reduced for any month in which the beneficiary works for an employer other than a railroad employer and earns more than a prescribed amount. For calendar year 2014, the exempt amounts are $15,480 for annuitants under full retirement age (FRA) and 41,400 for annuitants who have attained full retirement age. This limit applies only to earnings for months prior to the month in which FRA is attained. There is no restriction on earnings for annuitants over FRA.


Under the 1988 amendments to the RRA (P.L. 100-647, the Technical and Miscellaneous Revenue Act of 1988), the Tier II portion of the regular annuity and any supplemental annuity must be reduced by one dollar for each two dollars of Last Pre-Retirement Non-Railroad Employment (LPE) earnings for each month of such service, except that the reduction cannot exceed 50% of the Tier II and supplemental annuity amounts for the month to which such deductions apply. Prior to these amendments, an annuity was not payable for any month in which an annuitant had LPE earnings. Last Pre-Retirement Non-Railroad Employment generally refers to the annuitant’s last employment with a non-railroad person, company, or institution prior to retirement, which was performed at the same time as railroad employment or after the annuitant stopped railroad employment.


The provisions relating to the reduction or non-payment of annuities by reason of work are prescribed in 20 CFR 230.1 and 230.2.


2. Purposes of collecting/consequences of not collecting the information - Form G-19L, Annual Earnings Questionnaire, is used by the Railroad Retirement Board (RRB) to obtain the LPE earnings information needed to determine possible reductions in an annuity because of LPE earnings.


The form is used as part of the RRB's annual earnings monitoring program to determine whether the annuitant was paid correct annuity amounts during the last calendar year and if adjustments are required for the current year because of an annuitant's LPE earnings, or earnings in excess of the annual exempt amount.


Page 1 of the form explains to the annuitant the circumstances surrounding the release of Form G-19L.


Page 2 of the form is comprised of three parts to be completed as follows:


  • Part A is completed by the annuitant who has earnings from LPE in the past calendar year and/or in the current calendar year.


  • Part B is completed by the annuitant who has earnings from self-employment in the past calendar year and/or in the current calendar year.


  • Part C is completed by the annuitant who has earnings from other than LPE or self‑employment in the past calendar year and/or in the current calendar year.


In the majority of cases, Form G-19L is mailed to the respondent. The annuitant’s name and other identifying information are prefilled on the G-19L before release. The RRB also encloses Form G-77a, How Work Affects Your Railroad Retirement Benefits, along with the G-19L. The annuitant returns the completed Form G-19L to the RRB in the envelope provided for that purpose.


The RRB proposes no changes to Form G-19L.


3. Planned use of improved information technology or technical/ legal impediments to further burden reduction - The RRB has determined that the use of the Internet is not practicable because this form is initiated by the RRB with pre-filled data and the burden is at a marginal level.


4. Efforts to identify duplication - This information collection does not duplicate any other information collection.


5. Small business respondents - N.A.


6. Consequences of less frequent collections - Obtaining the employment and earnings information less frequently would affect the accurate payment of annuities under the RRA.


7. Special Circumstances - N.A.


8. Public Comments/Consultations outside the agency - In accordance with 5 CFR 1320.8(d), comments were invited from the public regarding the information collection. The notice to the public was published on page 3266 of the January 22, 2015, Federal Register. No requests for further information or comments were received.


9. Payments or gifts to respondents - None


10. Confidentiality - Privacy Act System of Records, RRB-22, Railroad Retirement Survivor and Pension Benefit System. In accordance with OMB Circular M-03-22, a Privacy Impact Assessment for this information collection was completed and can be found at http://www.rrb.gov/pdf/PIA/PIA-BPO.pdf.


11. Sensitive questions - There are no questions of a sensitive nature.


12. Estimate of respondent burden - The estimated respondent burden for the collection is unchanged as follows:


Current Burden


Form Number

Annual Responses

Time (Minutes)

Burden (Hours)

G-19L

300

15

75

Total

300


75


13. Estimate of annual cost burden to respondents or record keepers - N.A.


14. Estimate of cost to the Federal Government - N.A.

15. Explanation for change in burden - N.A.


16. Time schedule for data collection and publication - The results of this collection will not be published.


  1. Request to not display OMB expiration date - The G-19L is seldom revised. Given the costs associated with redrafting, reprinting and distributing the form in order to keep the appropriate OMB expiration date in place, the RRB requests authorization to not display the expiration date on the form.

18. Exceptions to Certification Statement - None


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File Typeapplication/msword
AuthorBDP-230
Last Modified ByMierzwa, Charles
File Modified2015-04-10
File Created2014-12-29

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