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Survivor Questionnaire
Survivor Questionnaire
OMB: 3220-0032
IC ID: 33842
OMB.report
RRB
OMB 3220-0032
ICR 202308-3220-007
IC 33842
( )
Documents and Forms
Document Name
Document Type
Form RL-94F (10-18)
Survivor Questionnaire
Form and Instruction
RL-94F (10-18) Survivor Questionnaire
Form RL-94F (10-18) - CURRENT.docx
Form and Instruction
RL-94F (XX-XX) Survivor Questionnaire
Form RL-94F (XX-XX) - PROPOSED.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Survivor Questionnaire
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR 234
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
RL-94F (10-18)
Survivor Questionnaire
Form RL-94F (10-18) - CURRENT.docx
No
Paper Only
Form and Instruction
RL-94F (XX-XX)
Survivor Questionnaire
Form RL-94F (XX-XX) - PROPOSED.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Survivor Compensation
Privacy Act System of Records
Title:
RRB-22, Railroad Retirement, Survivor and Pensioner Benefit System
FR Citation:
79 FR 58874
Number of Respondents:
5,450
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
5,450
0
0
0
0
5,450
Annual IC Time Burden (Hours)
959
0
0
0
0
959
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.