Application for Spouse Annuity Under the Railroad Retirement Act

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0042 can be found here:

Documents and Forms

Document Name Document Type
Form AA-3cert (all poss Application for Spouse Annuity Under the Railroad Retirement Act Form and Instruction
AA-3cert (all poss Application Summary and Certification Form AA-3cert (04-13) All possible.pdf Form and Instruction
AA-3cert (complete Application Summary and Certification Form AA-3cert (04-13) Completed.pdf Form
AA-3sum (all possi Application Summary Form AA-3sum (11-14) All Possible.pdf Form
AA-3sum (completed Application Summary Form AA-3sum (11-14) Completed.pdf Form
Form RL-1 (04-07).pdf RL-1 IC Document
Form RB-3 (11-08).pdf RB-3, Furnishing Evidence To Support Your Claim IC Document
Form RB-30 (01-16).pdf RB-30, Spouse/Divorced Spouse Annuity IC Document
Form RB-09 (03-09).pdf RB-9, Employee and Spouse Annuities - Events That Must Be Reported IC Document
Form AA-7 (01-12).pdf AA-7, Spouse/Divorced Application for Medicare IC Document
Form G-208 (01-14).pdf G-208, Public Service Pension Questionnaire IC Document
Form G-19F (02-16).pdf G-19F, Earnings Information Request IC Document
Form AA-3 (07-15).pdf AA-3 (07-15) Application for Spouse/Divorced Spouse Annuity IC Document
Form AA-3 proposed less than 10.pdf AA-3 (proposed) < than 10 responses IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Spouse Annuity Under the Railroad Retirement Act	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 216.50 20 CFR 218.11

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	AA-3cert (all possible)	Application Summary and Certification	Form AA-3cert (04-13) All possible.pdf	Yes	Yes	Fillable Printable
Form	AA-3cert (completed)	Application Summary and Certification	Form AA-3cert (04-13) Completed.pdf	Yes	Yes	Fillable Printable
Form	AA-3sum (all possible)	Application Summary	Form AA-3sum (11-14) All Possible.pdf	Yes	Yes	Fillable Printable
Form	AA-3sum (completed)	Application Summary	Form AA-3sum (11-14) Completed.pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records
Title: RRB-22, Railroad Retirement, Survivor and Pensioner Benefit System	FR Citation: 79 FR 58874

Number of Respondents: 11,700	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	11,700	650	11,050
Annual IC Time Burden (Hours)	5,733	409	5,324
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
RL-1	Form RL-1 (04-07).pdf	02/25/2010
RB-3, Furnishing Evidence To Support Your Claim	Form RB-3 (11-08).pdf	02/25/2010
RB-30, Spouse/Divorced Spouse Annuity	Form RB-30 (01-16).pdf	02/19/2016
RB-9, Employee and Spouse Annuities - Events That Must Be Reported	Form RB-09 (03-09).pdf	02/25/2010
AA-7, Spouse/Divorced Application for Medicare	Form AA-7 (01-12).pdf	12/05/2012
G-208, Public Service Pension Questionnaire	Form G-208 (01-14).pdf	02/19/2016
G-19F, Earnings Information Request	Form G-19F (02-16).pdf	02/19/2016
AA-3 (07-15) Application for Spouse/Divorced Spouse Annuity	Form AA-3 (07-15).pdf	02/26/2016
AA-3 (proposed) < than 10 responses	Form AA-3 proposed less than 10.pdf	02/26/2016

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