Application for Survivor Insurance Annuities

OMB 3220-0030

OMB 3220-0030

Under Section 2(d) of the Railroad Retirement Act, monthly survivor annuities are payable to surviving widow(er)s, parents, unmarried children, and in certain cases, divorced wives (husbands), mothers (fathers), remarried widow(er)s and grandchildren of deceased railroad employees. The collection obtains information needed by the RRB to determine entitlement to and the amount of the annuity applied for.

The latest form for Application for Survivor Insurance Annuities expires 2022-06-30 and can be found here.

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