Evidence of Marital Relationship - Living with Requirements

Evidence of Marital Relationship - Living with Requirements

OMB: 3220-0021

IC ID: 33823

Information Collection (IC) Details

View Information Collection (IC)

Evidence of Marital Relationship - Living with Requirements
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 219.3

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form G-124 (05-08) Statement of Marital Relationship Form G-124 (05-08).pdf No   Paper Only
Form G-124A (05-08) Statement Regarding Marriage Form G-124a (05-08).pdf No   Paper Only
Form and Instruction G-237 (05-08) Statement Regarding Marital Status Form G-237 (05-08).pdf No   Paper Only
Form G-238A (10-02) Statement Regarding Divorce or Annulment Form G-238a (10-02).pdf No   Paper Only
Form G-238 (10-02) Statement of Residence Form G-238 (10-02).pdf No   Paper Only
Form G-124 (Proposed) Statement of Marital Relationship Form G-124 (Proposed).pdf No   Paper Only
Form G-124A (Proposed) Statement Regarding Marriage Form G-124a (Proposed).pdf No   Paper Only
Form and Instruction G-237 (Proposed) Statement Regarding Marital Status Form G-237 (Proposed).pdf No   Paper Only
Form G-238 (Proposed) Statement of Residence Form G-238 (Proposed).pdf No   Paper Only
Form G-238A (Proposed) Statement Regarding Divorce or Annulment Form G-238A (Proposed).pdf No   Paper Only

Income Security General Retirement and Disability

RRB-22; Railroad Retirement, Survivor and Pensioner Benefit System   79 FR 58874

1,100 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,100 0 0 0 0 1,100
Annual IC Time Burden (Hours) 196 0 0 0 0 196
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Notice of Information Needed in Claim under Railroad Retirement Act Form G-242 (01-07).pdf 01/24/2012
RL-26, Transmittal Letter, Instruction Sheet Form RL-26F (05-08).pdf 01/24/2012
RL-57A-F, Transmittal letter Form RL-57A-F (10-82).pdf 01/24/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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