Information Collection

Application and Claim for Unemployment Benefits and Employment Service

IC 33827 under ICR 202006-3220-001 · OMB 3220-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0022 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form UI-1 (03-12) Application for Unemployment Benefits and Employment Service Application and Claim for Unemployment Benefits and Employment Service	Form
Form UI-3 (02-09) Claim for Unemployment Benefits Application and Claim for Unemployment Benefits and Employment Service	Form
Form UI-3 (Internet) (0 Claim for Unemployment Benefits Application and Claim for Unemployment Benefits and Employment Service	Form
Form UI-1 (Internet) (0 Application for Unemployment Benefits and Employment Service Application and Claim for Unemployment Benefits and Employment Service	Form
UI-1 (03-12) Application for Unemployment Benefits and Employment Ser Form UI-1 (03-12).pdf	Form
UI-3 (02-09) Claim for Unemployment Benefits Form UI-3 (02-09).pdf	Form
UI-3 (Internet) (0 Claim for Unemployment Benefits Form UI-3 (Internet) (08-04).pdf secure.RRB.gov/MainLine/PINPassword/login/Login.asp?App=RUIA	Form
UI-1 (Internet) (0 Application for Unemployment Benefits and Employment Ser Form UI-1 (Internet) (03-04).pdf secure.RRB.gov/MainLine/PINPassword/login/Login.asp?App=RUIA	Form
UB-10 (03-12).pdf UB-10, Unemployment Benefits for Railroad Employees (11-06)	IC Document

IC Title:

Application and Claim for Unemployment Benefits and Employment Service

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 325

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	UI-1 (03-12)		No		Paper Only
Form	UI-3 (02-09)		No		Paper Only
Form	UI-3 (Internet) (08-04)	https://secure.RRB.gov/MainLine/PINPassword/login/Login.asp?App=RUIA	Yes	Yes	Fillable Fileable Signable
Form	UI-1 (Internet) (03-04)	https://secure.RRB.gov/MainLine/PINPassword/login/Login.asp?App=RUIA	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records

Title: RRB-7, Applications for Unemployment Benefits and Placement Service

FR Citation: 79 FR 58874

Number of Respondents: 81,662

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 34 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	81,662	-14,478	96,140
Annual IC Time Burden (Hours)	8,901	-1,616	10,517
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
UB-10, Unemployment Benefits for Railroad Employees (11-06)		03/26/2014

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

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