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

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

Information Collection (IC) Details

View Information Collection (IC)

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

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G-88A.1 (09-18)	Request for Verification of Date Last Worked	Form G-88A1 (09-18).pdf	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)	Notice of Retirement and Verification of Date Last Worked	Form G-88A1 (Internet) (03-13).pdf	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 %

	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

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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