3220-0200

OMB No. 3220-0200

Justification

Designation of Contact Officials

RRB Form G-117a

1. Circumstances of information collection - Section 7(b)(6) of the Railroad Retirement Act (RRA) gives the Railroad Retirement Board (RRB) the authority to require railroad employers to furnish information and records that are necessary for the administration of the Act. Further, Section 9 of the RRA and Section 6 of the Railroad Unemployment Insurance Act (RUIA) requires railroad employers to file reports of compensation of employees. This information serves as the basis for calculating retirement, disability, and survivor awards as well as the payment of unemployment and sickness benefits.

2. Purposes of collecting/consequences of not collecting the information - Coordination between railroad employers and the RRB is essential for the RRB to properly administer the payment of benefits under the RRA and the RUIA. In order to enhance timely coordination activity, the RRB utilizes Form G-117a, Designation of Contact Officials.

Form G-117a is used by railroad employers to notify the RRB of the official designated to coordinate various functions under the RRA and the RUIA with agency staff. The form provides the RRB with the name, title, address, phone number, facsimile number, and E-mail address of the contact. Completion is voluntary.

The RRB proposes no changes to Form G-117a.

3. Planned use of improved information technology or technical/legal impediments to further burden reduction - Given the low-usage of Form G-117a, the RRB does not plan to automate the form at this time. It is available for downloading from the RRB’s website at http://www.rrb.gov/pdf/AandT/g117a.pdf.

4. Efforts to identify duplication - This information collection does not duplicate any other information collection.

5. Small business respondents - N.A.

6. Consequences of less frequent collection - Completion is voluntary.

7. Special circumstances - N.A.

8. Consultations outside the agency - In accordance with 5 CFR 1320.8(d), comments were invited from the public regarding the information collection. The notice to the public was published on page 89522 of the December 12, 2016, Federal Register. No comments or requests for additional information were received.

9. Payments or gifts to respondents - None

10. Confidentiality - N.A.

11. Sensitive questions - N.A.

12. Estimate of respondent burden - The estimated burden for the collection is unchanged as follows.

Current Burden

Form Number	Annual Responses	Time (Minutes)	Burden (Hours)
G-117a	100	15	25
Total	100		25

13. Estimated annual cost to respondents or record keepers - N.A.

14. Estimated cost to Federal Government - N.A.

15. Explanation for change in burden - N.A.

16 Time schedule for data collection and publication - N.A.

17. Request not display OMB expiration date - The G-117a is a low-usage form that is seldom revised. Given the costs associated with redrafting, reprinting, and distributing the form in order to keep the appropriate expiration date in place, the RRB requests the authority to not display the OMB expiration date on the form.

18. Exceptions to Certification Statement - None

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