Information Collection

Application for Employee Annuity Under the Railroad Retirement Act

IC 33796 under ICR 201602-3220-002 · OMB 3220-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0002 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AA-1 (07-15) Application for Employee Annuity Under the Railroad Retirement Act	Form and Instruction
AA-1 (07-15) Application for Employee Annuity Form AA-1 (07-15).pdf	Form and Instruction
AA-1d Application for Determination of Employee Disability Form AA-1d (02-14).pdf	Form and Instruction
AA-1 (proposed) Application for Employee Annuity Form AA-1 Proposed.pdf	Form and Instruction
AA-1cert (proposed Application Summary and Certification Form AA-1cert (Proposed) All Possible.pdf	Form
AA-1cert Application Summary and Certification Form AA-1cert (05-15).pdf	Form
AA-1cert (proposed Application Summary and Certification Form AA-1cert (Proposed) Completed.pdf	Form
AA-1sum (proposed) Application Summary Form AA-1sum (Proposed) All Possible.pdf	Form
AA-1sum (proposed) Application Summary Form AA-1sum Proposed (Completed).pdf	Form
AA-1sum (09-15) Application Summary Form AA-1sum (09-15).pdf	Form
AA-1d Application for Determination of Employee Disability Form AA-1d (Proposed).pdf	Form and Instruction

IC Title:

Application for Employee 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 20 CFR 220

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	AA-1 (07-15)	Application for Employee Annuity	Form AA-1 (07-15).pdf	No		Paper Only
Form and Instruction	AA-1d	Application for Determination of Employee Disability	Form AA-1d (02-14).pdf	No		Paper Only
Form and Instruction	AA-1 (proposed)	Application for Employee Annuity	Form AA-1 Proposed.pdf	No		Paper Only
Form	AA-1cert (proposed) (all possible)	Application Summary and Certification	Form AA-1cert (Proposed) All Possible.pdf	Yes	Yes	Fillable Printable
Form	AA-1cert	Application Summary and Certification	Form AA-1cert (05-15).pdf	Yes	Yes	Fillable Printable
Form	AA-1cert (proposed) (completed)	Application Summary and Certification	Form AA-1cert (Proposed) Completed.pdf	Yes	Yes	Fillable Printable
Form	AA-1sum (proposed) (all possible)	Application Summary	Form AA-1sum (Proposed) All Possible.pdf	Yes	Yes	Fillable Printable
Form	AA-1sum (proposed) (completed)	Application Summary	Form AA-1sum Proposed (Completed).pdf	Yes	Yes	Fillable Printable
Form	AA-1sum (09-15)	Application Summary	Form AA-1sum (09-15).pdf	Yes	Yes	Fillable Printable
Form and Instruction	AA-1d	Application for Determination of Employee Disability	Form AA-1d (Proposed).pdf	No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: RRB-22; Railroad Retirement, Survivor, and Pensioner Benefit System

FR Citation: 79 FR 58874

Number of Respondents: 12,720

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 83 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	15,325	-2,480	17,805
Annual IC Time Burden (Hours)	8,887	-227	9,114
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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