Public Service Pension Questionnaires

ICR 201703-3220-002

OMB: 3220-0136

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2017-04-27
IC Document Collections
IC ID
Document
Title
Status
33931 Modified
ICR Details
3220-0136 201703-3220-002
Active 201401-3220-010
RRB
Public Service Pension Questionnaires
Extension without change of a currently approved collection   No
Regular
Approved without change 06/19/2017
Retrieve Notice of Action (NOA) 04/28/2017
  Inventory as of this Action Requested Previously Approved
06/30/2020 36 Months From Approved 06/30/2017
1,170 0 1,170
294 0 294
0 0 0

A spouse or survivor annuity under the Railroad Retirement Act may be subjected to a reduction for a public service pension. The questionnaires obtain information needed to determine if the reduction applies and the amount of such reduction.

US Code: 45 USC 231f Name of Law: Railroad Retirement Act
  
None

Not associated with rulemaking

  82 FR 5614 01/18/2017
82 FR 15545 03/29/2017
No

1
IC Title Form No. Form Name
Public Service Pension Questionnaires G-208 (02-17), G-212 (02-17) Public Service Pension Questionnaire ,   Public Service Pension Monitoring Questionnaire

  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 1,170 1,170 0 0 0 0
Annual Time Burden (Hours) 294 294 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
Yes
No
No
No
Uncollected
Brian Foster 312 751-4826 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/28/2017


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