Medical Reports

ICR 202312-3220-002

OMB: 3220-0038

Federal Form Document

Forms and Documents

Document Name	Status
Form G-3EMP Medical Reports Form and Instruction	Modified
Form G-197 Authorization to Disclose Information to the Railroad Retirement Board Form and Instruction	Modified
Form RL-11D Medical Reports Form and Instruction	Modified
3220-0038 .docx Supporting Statement A	2023-12-27
SSA-4734-F4-SUP (08-85).pdf Supplementary Document	2016-09-28
SSA-827 (11-12).pdf Supplementary Document	2014-12-05

IC Document Collections

IC ID	Document Title	Status
33854	Medical Reports Form and Instruction	Modified
185886	Authorization to Disclose Information to the Railroad Retirement Board Form and Instruction	Modified
185885	Medical Reports Form and Instruction	Modified