Information Collection

Designation of Contact Officials

IC 34021 under ICR 202606-3220-004 · OMB 3220-0200.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form G-117a (10-23) Designation of Contact Officials Designation of Contact Officials	Form and Instruction
Form G-117a (XX-XX) Designation of Contact Officials Designation of Contact Officials	Form and Instruction
Form G-117a (Internet) Designation of Contact Officials Designation of Contact Officials	Form and Instruction
Form G-117a Internet (0 Designation of Contact Officials Designation of Contact Officials	Form and Instruction
G-117a (10-23) Designation of Contact Officials G-117a Paper (10-23).pdf www.rrb.gov/Employer/Forms/G-117a	Form and Instruction
G-117a (XX-XX) Designation of Contact Officials G-117a Paper (XX-XX) Proposed.pdf	Form and Instruction
G-117a (Internet) Designation of Contact Officials G-117a Paper (XX-XX) Proposed.pdf	Form and Instruction
G-117a Internet (0 Designation of Contact Officials G-117a Internet (08-22).pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	G-117a (10-23)	https://www.rrb.gov/Employer/Forms/G-117a	Yes	No	Fillable Printable
Form and Instruction	G-117a (XX-XX)		Yes	Yes	Fillable Printable
Form and Instruction	G-117a (Internet) (XX-XX)		Yes	Yes	Fillable Fileable
Form and Instruction	G-117a Internet (08-22)		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 95

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 79 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	95	-130	225
Annual IC Time Burden (Hours)	11	-12	23
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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