Information Collection

Railroad Separation Allowance or Severance Pay Report

IC 33976 under ICR 202111-3220-002 · OMB 3220-0173.

⚠️ Notice: This information collection may be referencing outdated material.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

2024-11-25 - Extension without change of a currently approved collection

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 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 (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
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
BA-9 (Internet) (P Report of Separation Allowance or Severance Pay ERSNet BA-9 Screens.docx	Form and Instruction
BA-9 (Internet) (P Report of Separation Allowance or Severance Pay ERSNet BA-9 Screens.docx	Form and Instruction
Form BA-12 (09-19).pdf Form BA-12	IC Document
Form BA-12 (09-19).pdf Form BA-12	IC Document
PL 19-03.pdf Program Letter 19-03	IC Document
PL 19-03.pdf Program Letter 19-03	IC Document
PL 08-05.pdf Program Letter - 08-05	IC Document
PL 08-05.pdf Program Letter - 08-05	IC Document

Information Collection (IC) Details

View Information Collection (IC)

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
Form and Instruction	BA-9 (Internet) (Proposed)	Report of Separation Allowance or Severance Pay	ERSNet BA-9 Screens.docx		Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

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)	239	-218	457
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Form BA-12	Form BA-12 (09-19).pdf	11/30/2021
Program Letter 19-03	PL 19-03.pdf	11/30/2021
Program Letter - 08-05	PL 08-05.pdf	11/30/2021

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