Statement Regarding Contributions and Support

ICR 201709-3220-005

OMB: 3220-0099

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2017-09-18
IC Document Collections
IC ID
Document
Title
Status
33902 Modified
ICR Details
3220-0099 201709-3220-005
Active 201407-3220-006
RRB
Statement Regarding Contributions and Support
Extension without change of a currently approved collection   No
Regular
Approved without change 11/22/2017
Retrieve Notice of Action (NOA) 09/20/2017
  Inventory as of this Action Requested Previously Approved
11/30/2020 36 Months From Approved 11/30/2017
100 0 100
259 0 259
0 0 0

Dependency on the employee for one-half support at the time of the employee's death can be a condition affecting eligibility for a survivor annuity provided for under Section 2 of the Railroad Retirement Act. One-half support is also a condition which may negate the public service pension offset in Tier I for a spouse or widow(er).

US Code: 45 USC 231f(b)(6) Name of Law: Railroad Retirement Act
  
None

Not associated with rulemaking

  82 FR 31109 07/05/2017
82 FR 43052 09/13/2017
No

1
IC Title Form No. Form Name
Statement Regarding Contributions and Support G-134 Statement Regarding Contributions and Support

  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 100 100 0 0 0 0
Annual Time Burden (Hours) 259 259 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    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.
09/20/2017


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