Form AA-1rec (03-16)

United States of America
Railroad Retirement Board

CURRENT

Form AA-1rec (03-16)

Application for Railroad Retirement Annuity - Receipt for Claim
Applicant’s Name and Address
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Name
Application Filing Date
(Printed if application is for Employee or Disabled Employee Annuity.)
Your application for (Application Type) has been released and will be processed as quickly as
possible. If you do not receive notification about your application by ________________ you
should contact the field office shown below.
(Printed if application is for Medicare.)
Your application for Medicare has been released and will be processed as quickly as possible.
If you change your address, or if there is some other change that may affect your application,
you or your representative should report the change at once. If you have any questions, we will
be glad to help you. You can report changes either by telephone, mail, or in person, whichever
you prefer. Most Railroad Retirement Board offices are open to the public from 9:00 AM to
3:30 PM, Monday through Friday.
The changes to be reported are listed below.
Always Report These Changes to the RRB
 Railroad Work – If you return work for a railroad or railroad labor organization, or return to
work in any capacity in the railroad industry. (Printed if applicant is employee or disabled
employee.)
 If you change the date you will cease working for __________. On your application you
stated that your last day of employment would be _____________.
 Social Security – If you file for social security benefits based on any person’s earnings
record.
 Public Pension – If you receive a lump-sum or begin to receive a pension based on
earnings not covered by the Social Security Administration or Railroad Retirement Board.
 Pension – If you receive a lump-sum payment or begin to receive a monthly pension from
your railroad employer.

 Other Benefits – If you begin to receive worker’s compensation or a public disability
benefit.
 Settlement – If you receive a settlement with credit for railroad service as “pay-for-time-lost”
for months after _________________.
 Employment – If you return to work for ________
.
 Employment – If you change the date of last nonrailroad employment. On your application
you said your last day of employment with ___________ would be _____________.
 Employment - If you cease working for
.
 Earnings – If you work for any employer or performed any self-employment work.
 Earnings – If your earnings change
 On your application you told us you expected your total nonrailroad earnings for (current
year) to be $ ________.
 On your application you told us you expected your total nonrailroad earnings for (current
year) to be less than $ ________.
 You are earning more than $ ______.
 You are not earning more than $ _____.
 Address – If your address changes, even if your payments are sent to a financial
organization. (Print on employee and disabled employee applications.)
 Address – If your address changes. (Print on Medicare only application.)
 Bank Account – If your financial organization or the account number at your financial
organization changes.
 Criminal Offense – If you are confined in a jail, prison, penal institution, or correctional
facility due to a conviction for a criminal offense.
 Death or Disability – Your representative should notify the RRB immediately if you die or
become unable to handle your own benefits.
How to Report Changes
When a change occurs after you have begun receiving your annuity, you should report the
change at once. You or your representative can make the reports by telephone, mail or in
person, whichever you prefer.
(Print if application is for an employee or disabled employee annuity and applicant is under FRA.)
In most cases, we calculate how much to reduce your annuity because of your earnings based
on either the earnings estimate you gave us when you applied for benefits, or on reports
submitted by employers to the Social Security Administration. As a reminder, you should report
your earnings (1) when we ask for a report of your earnings or (2) if any of the following
happens:

 You stop working;
 You start working and expect to earn more than the annual exempt amount;
 Your employment is not covered under the Social Security Act (i.e., FICA taxes are not
deducted from your pay);
 You work for a railroad or railroad labor organization; or
 You return to work for your last pre-retirement nonrailroad employer.

To report any changes or ask questions, you should contact:
(Field Office Address and Toll-Free Telephone Number)

If for some reason you are unable to contact that office, you should contact:
U.S. Railroad Retirement Board
844 N Rush Street
Chicago, Illinois 60611-1275
http://www.rrb.gov