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Federal forms, ICRs, and supporting documents

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Claimant Appeal Under the Railroad Retirement Act or Railroad Unemployment Insurance Act

IC 33804 under ICR 202411-3220-002 · OMB 3220-0007.

Documents and Forms
Document Name
Document Type
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Form
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IC Document
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Claimant Appeal Under the Railroad Retirement Act or Railroad Unemployment Insurance Act
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 260 20 CFR 320

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HA-1 Claimant Appeal Under the Railroad Retirement Act or Railroad Unemployment Insurance Act HA-1 (03-22) Current.pdf Yes No Printable Only
Form HA-1 (XX-XX) Proposed Claimant Appeal Under the Railroad Retirement Act or Railroad Unemployment Insurance Act Form HA-1 (XX-XX) Proposed.pdf Yes No Printable Only

Litigation and Judicial Activities Resolution Facilitation

RRB-17, Appeal Decisions from Initial Denial for Benefits Under the Provisions of the Railroad Retirement Act   79 FR 58874

300 0
   
Individuals or Households
 
   0 %

  Requested 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 300 0 0 0 0 300
Annual IC Time Burden (Hours) 100 0 0 0 0 100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Form HA-2, Filing Appeals Under the Railroad Retirement Act and the Railroad Unemployment Insurance Act Form HA-2 (06-21).pdf 06/29/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.