Information Collection Request
Medical Reports
ICR 202312-3220-002 · OMB 3220-0038 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form G-3EMP Medical Reports |
Form and Instruction | Modified | Repair queued |
| Form G-197 Authorization to Disclose Information to the Railroad Retirement Board |
Form and Instruction | Modified | Available |
| Form RL-11D Medical Reports |
Form and Instruction | Modified | Repair queued |
 3220-0038 .docx |
Supporting Statement A | Uploaded 2023-12-27 | Missing upstream |
 SSA-4734-F4-SUP (08-85).pdf |
Supplementary Document | Uploaded 2016-09-28 | Repair queued |
| SSA-827 (11-12).pdf |
Supplementary Document | Uploaded 2014-12-05 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 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 |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | RRB |
| OMB Control No | 3220-0038 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 201912-3220-002 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |