Application for Employee Annuity Under the Railroad Retirement Act

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0002 can be found here:

Documents and Forms

Document Name Document Type
Form AA-1 Application for Employee Annuity Under the Railroad Retirement Act Form and Instruction
AA-1 Application for Employee Annuity Form AA-1 (05-17).pdf Form and Instruction
AA-1d Application for Determination of Employee Disability Form AA-1D (05-17).pdf Form and Instruction
AA-1 (Proposed) Application for Employee Annuity Form AA-1 (Proposed).pdf Form and Instruction
AA-1cert (Proposed Application Summary and Certification Form AA-1cert (Proposed) All Possible.pdf Form
AA-1cert Application Summary and Certification Form AA-1cert (05-17).pdf Form
AA-1cert (Proposed Application Summary and Certification Form AA-1cert (Proposed) Completed.pdf Form
AA-1sum (Proposed) Application Summary Form AA-1sum (Proposed) All Possible.pdf Form
AA-1sum (Proposed) Application Summary Form AA-1sum (Proposed) Completed.pdf Form
AA-1sum Application Summary Form AA-1sum (05-17).pdf Form
AA-1 (Internet) Description and Screens.pdf AA-1 (Internet) Description and Screens IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Employee Annuity Under the Railroad Retirement Act	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 220 20 CFR 216

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	AA-1	Application for Employee Annuity	Form AA-1 (05-17).pdf	No		Paper Only
Form and Instruction	AA-1d	Application for Determination of Employee Disability	Form AA-1D (05-17).pdf	No		Paper Only
Form and Instruction	AA-1 (Proposed)	Application for Employee Annuity	Form AA-1 (Proposed).pdf	No		Paper Only
Form	AA-1cert (Proposed) (All Possible)	Application Summary and Certification	Form AA-1cert (Proposed) All Possible.pdf	Yes	Yes	Fillable Printable
Form	AA-1cert	Application Summary and Certification	Form AA-1cert (05-17).pdf	Yes	Yes	Fillable Printable
Form	AA-1cert (Proposed) (Completed)	Application Summary and Certification	Form AA-1cert (Proposed) Completed.pdf	Yes	Yes	Fillable Printable
Form	AA-1sum (Proposed) (All Possible)	Application Summary	Form AA-1sum (Proposed) All Possible.pdf	Yes	Yes	Fillable Printable
Form	AA-1sum (Proposed) (Completed)	Application Summary	Form AA-1sum (Proposed) Completed.pdf	Yes	Yes	Fillable Printable
Form	AA-1sum	Application Summary	Form AA-1sum (05-17).pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: RRB-22; Railroad Retirement, Survivor, and Pensioner Benefit System	FR Citation: 79 FR 58874

Number of Respondents: 12,720	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 83 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	15,325	0	15,325
Annual IC Time Burden (Hours)	9,750	863	8,887
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
AA-1 (Internet) Description and Screens	AA-1 (Internet) Description and Screens.pdf	11/22/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.