OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Earnings Information Request

IC 33996 under ICR 202405-3220-004 · OMB 3220-0184.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Earnings Information Request
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 230

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction G-19F (03-16) Earnings Information Request Form G-19F (03-16).pdf No   Paper Only
Form and Instruction Form G-19F (Web) Earnings Information Request G-19F (Web).pdf Yes No Fillable Printable

Income Security General Retirement and Disability

RRB-22; Railroad Retirement, Survivor and Pension Benefit System   79 FR 58874

700 0
   
Individuals or Households
 
   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 700 0 -200 0 0 900
Annual IC Time Burden (Hours) 93 0 -27 0 0 120
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
G-254; Continuing Disability Report Form G-254 (08-17).pdf 05/16/2024
G-19L; Annual Earnings Questionnaire Form G-19L (08-12).pdf 02/15/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.