Employer Reporting

OMB 3220-0005

OMB 3220-0005

Under the Railroad Retirement Act and the Railroad Unemployment Insurance Act, railroad employers are required to report service and compensation for employees needed to determine eligibility to and the amounts of benefits paid.

The latest form for Employer Reporting expires 2022-09-30 and can be found here.

All Historical Document Collections
Extension without change of a currently approved collection 2022-09-21
Approved without change
Revision of a currently approved collection 2019-04-30
Approved without change
Extension without change of a currently approved collection 2016-03-22
Approved without change
Revision of a currently approved collection 2013-02-05
Approved without change
Extension without change of a currently approved collection 2010-12-29
Approved without change
Revision of a currently approved collection 2007-10-26
Approved with change
Revision of a currently approved collection 2006-10-25
Approved without change
Revision of a currently approved collection 2003-07-31
Approved without change
Revision of a currently approved collection 2001-06-22
Approved without change
Revision of a currently approved collection 2001-04-20
Approved without change
Revision of a currently approved collection 2000-09-21
Approved without change
Extension without change of a currently approved collection 1997-10-21
Approved without change
Revision of a currently approved collection 1994-09-30
Approved without change
Revision of a currently approved collection 1991-05-31
Approved without change
Revision of a currently approved collection 1988-05-09
Approved without change
Extension without change of a currently approved collection 1987-11-30
Approved without change
Revision of a currently approved collection 1986-03-31
Approved without change
Revision of a currently approved collection 1985-01-22
Approved without change
Revision of a currently approved collection 1981-12-29
Approved with change
No material or nonsubstantive change to a currently approved collection 1981-06-23
Approved with change
No material or nonsubstantive change to a currently approved collection 1981-06-10
Approved with change
No material or nonsubstantive change to a currently approved collection 1981-05-29
Approved with change
No material or nonsubstantive change to a currently approved collection 1981-04-24
Approved without change
Extension without change of a currently approved collection 1980-04-02
Approved without change
Revision of a currently approved collection 1979-03-13
Approved without change
Extension without change of a currently approved collection 1975-08-19
OMB Details

AA-12 Notice of Death and Statement of Compensation

Federal Enterprise Architecture: Income Security - Survivor Compensation

Form AA-12 (01-19)Notice of Death and Request for Service Needed for Eligibilitywww.rrb.gov/sites/default/files/2019-01/AA-12%20(01-19).pdfForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.


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