BA-15 (Proposed) Report of Stock Options and Other Payments

---

Overview

Form
Instructions
Data Layout

---

Sheet 1: Form

UNITED STATES OF AMERICA											PROPOSED														Form Approved
RAILROAD RETIREMENT BOARD																									OMB No. 3220-0203
Medicare Wages, RRTA Gross Compensation, Stock Options and Other Payments
1.	2.	3.	4.	5.	6.	7.	8.	9.	10.	11.	12.	13.	14.	15.	16.	17.	18.	19.	20.	21.	22.	23.	24.	25.	26.	27.
I = Initial; R = Replacement	Year being reported (CCYY).	BA Number	Employee's SSN	Last Name (20)	First Name (15)	MI	Filler, leave blank	Medicare Q1 - 10 positions ($$$$$$$$¢¢)	Medicare Q2 - 10 positions ($$$$$$$$¢¢)	Medicare Q3 - 10 positions ($$$$$$$$¢¢)	Medicare Q4 - 10 positions ($$$$$$$$¢¢)	Filler, leave blank	RRTA Q1 - 10 positions ($$$$$$$$¢¢)	RRTA Q2 - 10 positions ($$$$$$$$¢¢)	RRTA Q3 - 10 positions ($$$$$$$$¢¢)	RRTA Q4 - 10 positions ($$$$$$$$¢¢)	Filler, leave blank	NQSOs Q1 - 10 positions ($$$$$$$$¢¢)	NQSOs Q2 - 10 positions ($$$$$$$$¢¢)	NQSOs Q3 - 10 positions ($$$$$$$$¢¢)	NQSOs Q4 - 10 positions ($$$$$$$$¢¢)	Filler, leave blank	Other Payments Q1 - 10 positions ($$$$$$$$¢¢)	Other Payments Q2 - 10 positions ($$$$$$$$¢¢)	Other Payments Q3 - 10 positions ($$$$$$$$¢¢)	Other Payments Q4 - 10 positions ($$$$$$$$¢¢)
Form BA-15 (MM-YY)

---

Sheet 2: Instructions

---

Sheet 3: Data Layout

Electronic File Format for Form BA-15
Report of Stock Options and Other Payments
Field Length	Record Position	Data and Instructions
1	1	I = Initial; R = Replacement
4	2-5	Year being reported (CCYY).
4	6-9	Four-digit employer BA number assigned by the Railroad Retirement Board.
9	10-18	Employee's social security account number.
20	19-38	First twenty (20) characters of the employee's surname. Spaces in such names as O Grady or De La Cross are acceptable.
15	39-53	First fifteen (15) characters of the employee's first name.
1	54	Employee’s middle initial.
1	55	Filler, leave blank
10	56-65	Medicare Wages First Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	66-75	Medicare Wages Second Quarter Amount -10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	76-85	Medicare Wages Third Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	86-95	Medicare Wages Fourth Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
1	96	Filler, leave blank
10	97-106	RRTA Gross Compensation First Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	107-116	RRTA Gross Compensation Second Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	117-126	RRTA Gross Compensation Third Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	127-136	RRTA Gross Compensation Fourth Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
1	137	Filler, leave blank
10	138-147	Non-Qualified Stock Option First Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	148-157	Non-Qualified Stock Option Second Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	158-167	Non-Qualified Stock Option Third Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	168-177	Non-Qualified Stock Option Fourth Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
1	178	Filler, leave blank
10	179-188	Other Payments First Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	189-198	Other Payments Second Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	199-208	Other Payments Third Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
10	209-218	Other Payments Fourth Quarter Amount - 10 positions ($$$$$$$$¢¢), preceded by zero(s) if necessary.
82	219-300	Blank Filler (for future expansion)
NOTE: If there are no earnings for the quarter, zero-fill.