Application for Spouse Annuity Under the Railroad Retirement Act

Forms and Documents

Document Name	Status
Form AA-3cert (all poss Application for Spouse Annuity Under the Railroad Retirement Act Form and Instruction	Modified
3220-0042.doc Supporting Statement A	2016-02-26

IC Document Collections

IC ID	Document Title	Status
33861	Application for Spouse Annuity Under the Railroad Retirement Act Form and Instruction	Modified

ICR Details

OMB Control No: 3220-0042	ICR Reference No: 201602-3220-001
Status: Historical Active	Previous ICR Reference No: 201212-3220-001
Agency/Subagency: RRB	Agency Tracking No:
Title: Application for Spouse Annuity Under the Railroad Retirement Act
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/30/2016
	Date Received in OIRA: 02/26/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved	03/31/2016
Responses	11,700	0	11,050
Time Burden (Hours)	5,733	0	5,324
Cost Burden (Dollars)	0	0	0

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Abstract: The Railroad Retirement Act provides for the payment of annuities to spouses of railroad retirement annuitants who meet the requirements under the Act. The application obtains information supporting the claim for benefits based on being a spouse of an annuitant. The information is used for determining entitlement to and amount of the annuity applied for.

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Authorizing Statute(s): US Code: 45 USC 231a Name of Law: Railroad Retirement Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 75140	12/01/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 8263	02/18/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for Spouse Annuity Under the Railroad Retirement Act	AA-3sum (completed) , AA-3sum (all possible) , AA-3cert (all possible), AA-3cert (completed)	Application Summary and Certification ,   Application Summary and Certification ,   Application Summary ,   Application Summary

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	11,700	11,050	0	0	650	0
Annual Time Burden (Hours)	5,733	5,324	0	0	409	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Removing manual Form AA-3 from the information collection due to less than 10 annual responses a year, decreases the annual responses by 250 and the burden hours by 242. However, due to improved record keeping which allows for a more accurate count, we have increased the AA-3cert annual responses by 1000, from 3,700 to 4,700 and the burden hours by 500, from 1,850 to 2,350. We have decreased the annual responses of Form AA-3sum by 100, from 7,100 to 7,000 and the burden hours by 49, from 3,432 to 3,383. We have shown the changes as an adjustment.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/26/2016

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