Information Collection

G-88a.1 Request for Verification of Last Date Carried on Payroll

IC 45673 under ICR 202601-3220-001 · OMB 3220-0005.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form G-88A.1 (09-18) Request for Verification of Date Last Worked G-88a.1 Request for Verification of Last Date Carried on Payroll	Form
Form G-88A.1 (Internet) Notice of Retirement and Verification of Date Last Worked G-88a.1 Request for Verification of Last Date Carried on Payroll	Form and Instruction
G-88A.1 (09-18) Request for Verification of Date Last Worked Form G-88A1 (09-18).pdf www.rrb.gov/sites/default/files/2018-09/Form%20G-88A.1%20%2809-18%29.pdf	Form
G-88A.1 (Internet) Notice of Retirement and Verification of Date Last Worke Form G-88A1 (Internet) (03-13).pdf secure.rrb.gov/ERSNet/login.aspx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 209.7

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G-88A.1 (09-18)			https://www.rrb.gov/sites/default/files/2018-09/Form%20G-88A.1%20%2809-18%29.pdf	Yes	No	Printable Only
Form and Instruction	G-88A.1 (Internet) (03-13)			https://secure.rrb.gov/ERSNet/login.aspx	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: RRB 22 - Railroad Retirement Survivor Pensioner and Benefit System

FR Citation: 79 FR 58874

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	500	-4	504
Annual IC Time Burden (Hours)	35	-28	63
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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