Information Collection

RUIA Continuing Entitlement

IC 33830 under ICR 202403-3220-001 · OMB 3220-0025.

Documents and Forms

Document Name Document Type
Form UI-9 (06-17) RUIA Continuing Entitlement Form
UI-9 (06-17) Statement of Employment and Wages Form UI-9 (06-17).pdf Form
UI-9 (06-17) Statement of Employment and Wages Form UI-9 (06-17).pdf Form
UI-44 (08-17) Claim for Credit for Military Service Form UI-44 (08-17).pdf Form and Instruction
UI-44 (08-17) Claim for Credit for Military Service Form UI-44 (08-17).pdf Form and Instruction
ID-4U (05-17) Form Letter; Advising of Service and Earnings Requiremen Form ID-4U (06-17).pdf Form and Instruction
ID-4U (05-17) Form Letter; Advising of Service and Earnings Requiremen Form ID-4U (06-17).pdf Form and Instruction
ID-4X (06-17) Form Letter; Advising of Service/Earnings Requirements f Form ID-4X (05-13).pdf Form and Instruction
ID-4X (06-17) Form Letter; Advising of Service/Earnings Requirements f Form ID-4X (05-13).pdf Form and Instruction
Form ID-4 (05-13).pdf Form Letter ID-4; Requesting Additional Information on Wages and Service IC Document
Form ID-4 (05-13).pdf Form Letter ID-4; Requesting Additional Information on Wages and Service IC Document
Form ID-4S-2 (05-13).pdf Form Letter ID-4-S-2; Advising of Service and Earnings Requirements for RUIA Benefits IC Document
Form ID-4S-2 (05-13).pdf Form Letter ID-4-S-2; Advising of Service and Earnings Requirements for RUIA Benefits IC Document
Form ID-4S-1 (05-13).pdf Form Letter ID-4-S-1, Advising of Service and Earnings Requirements for RUIA Benefits IC Document
Form ID-4S-1 (05-13).pdf Form Letter ID-4-S-1, Advising of Service and Earnings Requirements for RUIA Benefits IC Document
Form ID-32N (05-04).pdf Form Letter ID-32N; Establishing Extended Sickness Benefits and Data on Individual Service IC Document
Form ID-32N (05-04).pdf Form Letter ID-32N; Establishing Extended Sickness Benefits and Data on Individual Service IC Document
Form ID-19 (08-14).pdf Form Letter ID-19, Establishing Military Service Credits IC Document
Form ID-19 (08-14).pdf Form Letter ID-19, Establishing Military Service Credits IC Document
Form ID-4F (04-15).pdf Form Letter ID-4F, Advising of Ineligibility for Unemployment Benefits IC Document
Form ID-4F (04-15).pdf Form Letter ID-4F, Advising of Ineligibility for Unemployment Benefits IC Document
Form ID-4Y (04-15).pdf Form Letter ID-4Y, Advising of Ineligibility for Sickness Benefits IC Document
Form ID-4Y (04-15).pdf Form Letter ID-4Y, Advising of Ineligibility for Sickness Benefits IC Document
Form ID-20-1 (04-15).pdf Form Letter ID-20-1, Advising that Normal Unemployment Benefits are about to be Exhausted IC Document
Form ID-20-1 (04-15).pdf Form Letter ID-20-1, Advising that Normal Unemployment Benefits are about to be Exhausted IC Document
Form ID-20-2 (04-15).pdf Form Letter ID-20-2, Advising that Normal Sickness Benefits are about to be Exhausted IC Document
Form ID-20-2 (04-15).pdf Form Letter ID-20-2, Advising that Normal Sickness Benefits are about to be Exhausted IC Document
Form ID-20-4 (04-15).pdf Form ID-20-4, Advising that Normal Sickness Benefits are about to Exhausted/Non-Entitlement IC Document
Form ID-20-4 (04-15).pdf Form ID-20-4, Advising that Normal Sickness Benefits are about to Exhausted/Non-Entitlement IC Document
Form UI-23 (08-16).pdf Form UI-23, Statement of Service for Railroad Unemployment Insurance Benefits IC Document
Form UI-23 (08-16).pdf Form UI-23, Statement of Service for Railroad Unemployment Insurance Benefits IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RUIA Continuing Entitlement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 336 20 CFR 335 20 CFR 325

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	UI-9 (06-17)	Statement of Employment and Wages	Form UI-9 (06-17).pdf	No	Paper Only
Form and Instruction	UI-44 (08-17)	Claim for Credit for Military Service	Form UI-44 (08-17).pdf	No	Paper Only
Form and Instruction	ID-4U (05-17)	Form Letter; Advising of Service and Earnings Requirements for RUIA Benefits	Form ID-4U (06-17).pdf	No	Paper Only
Form and Instruction	ID-4X (06-17)	Form Letter; Advising of Service/Earnings Requirements for Sickness Benefits	Form ID-4X (05-13).pdf	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records
Title: RRB-21, Railroad Unemployment and Sickness Insurance Benefit System	FR Citation: 79 FR 58874

Number of Respondents: 139	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	139	139
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Form Letter ID-4; Requesting Additional Information on Wages and Service	Form ID-4 (05-13).pdf	08/28/2013
Form Letter ID-4-S-2; Advising of Service and Earnings Requirements for RUIA Benefits	Form ID-4S-2 (05-13).pdf	08/28/2013
Form Letter ID-4-S-1, Advising of Service and Earnings Requirements for RUIA Benefits	Form ID-4S-1 (05-13).pdf	08/28/2013
Form Letter ID-32N; Establishing Extended Sickness Benefits and Data on Individual Service	Form ID-32N (05-04).pdf	08/28/2013
Form Letter ID-19, Establishing Military Service Credits	Form ID-19 (08-14).pdf	04/21/2017
Form Letter ID-4F, Advising of Ineligibility for Unemployment Benefits	Form ID-4F (04-15).pdf	04/21/2017
Form Letter ID-4Y, Advising of Ineligibility for Sickness Benefits	Form ID-4Y (04-15).pdf	04/21/2017
Form Letter ID-20-1, Advising that Normal Unemployment Benefits are about to be Exhausted	Form ID-20-1 (04-15).pdf	04/21/2017
Form Letter ID-20-2, Advising that Normal Sickness Benefits are about to be Exhausted	Form ID-20-2 (04-15).pdf	04/21/2017
Form ID-20-4, Advising that Normal Sickness Benefits are about to Exhausted/Non-Entitlement	Form ID-20-4 (04-15).pdf	04/21/2017
Form UI-23, Statement of Service for Railroad Unemployment Insurance Benefits	Form UI-23 (08-16).pdf	04/21/2017

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