Placement Service

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form UI-35 (03-07) Field Office Record of Claimant Interview	Form	Modified	Available
Form ES-21 (11-07) Referral to State Employment Service	Form	Modified	Available
Form ES-2 (11-07) Supplemental Information for Central Register	Form	Modified	Available
Form ES-21c (07-05) Report of State Employment Service Office	Form	Modified	Available
3220-0057.doc	Supporting Statement A	Uploaded 2017-03-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
33872	Placement Service	Form	Modified	Field Office Record of Claimant Interview
33872	Placement Service	Form	Modified	Referral to State Employment Service
33872	Placement Service	Form	Modified	Supplemental Information for Central Register
181794	Report of State Employment Service Office	Form	Modified	Report of State Employment Service Office
181724	Railroad Job Vacancies List	Instruction	Modified

ICR Details

OMB Control No: 3220-0057	ICR Reference No: 201702-3220-001
Status: Historical Active	Previous ICR Reference No: 201401-3220-002
Agency/Subagency: RRB	Agency Tracking No:
Title: Placement Service
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/09/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/10/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	05/31/2017
Responses	11,325	0	23,000
Time Burden (Hours)	953	0	1,452
Cost Burden (Dollars)	0	0	0

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Abstract: Under the RUIA, the Railroad Retirement Board provides job placement assistance for unemployed railroad workers. The collection obtains information from job applicants, railroad employers, and State Employment Service offices for use in placement, for providing referrals for job openings, reports of referral results and for verifying and monitoring claimant eligibility.

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Authorizing Statute(s): US Code: 45 USC Chapter 11 Sec. 362 (i) Name of Law: Railroad Unemployment Insurance 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:
	81 FR 89521	12/12/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 11663	02/24/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Placement Service	ES-2 (11-07) , ES-21 (11-07), UI-35 (03-07)	Supplemental Information for Central Register ,   Referral to State Employment Service ,   Field Office Record of Claimant Interview
Railroad Job Vacancies List
Report of State Employment Service Office	ES-21c (07-05)	Report of State Employment Service Office

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ICR Summary of Burden

table that charts list 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	11,325	23,000	0	0	-11,675	0
Annual Time Burden (Hours)	953	1,452	0	0	-499	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:

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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: 03/10/2017

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