Information Collection

Railroad Separation Allowance or Severance Pay Report

IC 33976 under ICR 201810-3220-002 · OMB 3220-0173.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0173 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BA-9 (10-15) Railroad Separation Allowance or Severance Pay Report	Form and Instruction
BA-9 Instructions (Electronic Format).pdf www.rrb.gov/sites/default/files/2017-06/RERI-App.%20I_Form%20BA-9.pdf	Instruction
BA-9 (10-15) Report of Separation Allowance or Severance Pay Form BA-9 (10-15).pdf www.rrb.gov/sites/default/files/2018-07/BA-9.pdf	Form and Instruction
BA-9 (secure E-mai Report of Separation Allowance or Severance Pay Report Program Letter 2008-05 (secure E-mail and FTP).pdf www.rrb.gov/sites/default/files/2018-03/PL%2008-05.pdf	Form and Instruction

IC Title:

Railroad Separation Allowance or Severance Pay Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 209.14

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BA-9 (10-15)	Report of Separation Allowance or Severance Pay	Form BA-9 (10-15).pdf	https://www.rrb.gov/sites/default/files/2018-07/BA-9.pdf	Yes	No	Printable Only
Instruction			BA-9 Instructions (Electronic Format).pdf	https://www.rrb.gov/sites/default/files/2017-06/RERI-App.%20I_Form%20BA-9.pdf	Yes	No	Printable Only
Form and Instruction	BA-9 (secure E-mail - File Transfer Protocol)	Report of Separation Allowance or Severance Pay Report	Program Letter 2008-05 (secure E-mail and FTP).pdf	https://www.rrb.gov/sites/default/files/2018-03/PL%2008-05.pdf	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: RRB-5; Master File of Railroad Employee's Creditable Compensation

FR Citation: 79 FR 58874

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 72 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	360	0	360
Annual IC Time Burden (Hours)	457	218	239
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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