OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Application for Survivor Insurance Annuities

OMB 3220-0030 ยท RRB.

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 2026-07-31 and is listed under ICR 202404-3220-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form AA-19a (XX-XX) - P Application for Determination of Child's DisabilityForm and Instruction
Form AA-17b (XX-XX) - P Application for Determination of Widow(ers) DisabilityForm and Instruction
Form AA-17sum (01-19) ( Application SummaryForm
Form AA-17sum (01-19) ( Application SummaryForm
Form AA-17cert (09-15) Application Summary and CertificationForm
Form AA-17cert (09-15)( Application Summary and CertificationForm
Form AA-19a (10-07) Application for Determination of Child's DisabilityForm and Instruction
Form AA-17b (10-07) Application for Determination of Widow(ers) DisabilityForm and Instruction
3220-0030_Final.docxSupporting Statement A
Request OMB Approval of NonSubstantive Change to ICR 3220-0030_Signed.pdfJustification for No Material/Nonsubstantive Change
Application for Survivor Insurance Annuities Form and Instruction
Application for Survivor Insurance Annuities Form and Instruction
Application for Survivor Insurance Annuities Form
Application for Survivor Insurance Annuities Form
Application for Survivor Insurance Annuities Form
Application for Survivor Insurance Annuities Form
Application for Survivor Insurance Annuities Form and Instruction
Application for Survivor Insurance Annuities Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202411-3220-011 Revision of a currently approved collection 2025-01-21
202404-3220-001 No material or nonsubstantive change to a currently approved collection 2024-04-03 Approved without change
202206-3220-002 Extension without change of a currently approved collection 2022-06-13 Approved without change
201812-3220-003 Revision of a currently approved collection 2019-03-18 Approved without change
201601-3220-001 Revision of a currently approved collection 2016-02-29 Approved without change
201201-3220-004 Revision of a currently approved collection 2012-11-29 Approved without change
200907-3220-002 Extension without change of a currently approved collection 2009-07-24 Approved without change
200703-3220-004 Revision of a currently approved collection 2007-04-27 Approved without change
200403-3220-001 Extension without change of a currently approved collection 2004-03-04 Approved without change
200102-3220-003 Revision of a currently approved collection 2001-02-23 Approved without change
199808-3220-002 Extension without change of a currently approved collection 1998-08-20 Approved without change
199605-3220-003 Revision of a currently approved collection 1996-05-31 Approved without change
199509-3220-009 No material or nonsubstantive change to a currently approved collection 1995-09-30 Approved without change
199212-3220-002 Revision of a currently approved collection 1992-12-31 Approved without change
199109-3220-004 No material or nonsubstantive change to a currently approved collection 1991-09-23 Approved with change
198910-3220-002 Revision of a currently approved collection 1989-10-17 Approved without change
198904-3220-010 No material or nonsubstantive change to a currently approved collection 1989-04-07 Approved with change
198709-3220-005 No material or nonsubstantive change to a currently approved collection 1987-09-30 Approved with change
198606-3220-008 Revision of a currently approved collection 1986-06-26 Approved without change
198509-3220-004 No material or nonsubstantive change to a currently approved collection 1985-09-06 Approved with change
198408-3220-002 No material or nonsubstantive change to a currently approved collection 1984-08-22 Approved with change
198305-3220-003 Reinstatement with change of a previously approved collection 1983-05-03 Approved without change
198301-3220-003 Extension without change of a currently approved collection 1983-01-03 Withdrawn and continue
198201-3220-001 Revision of a currently approved collection 1982-01-11 Approved without change
198105-3220-040 No material or nonsubstantive change to a currently approved collection 1981-05-29 Approved with change
197711-3220-003 Revision of a currently approved collection 1977-11-08 Approved without change
197602-3220-001 No material or nonsubstantive change to a currently approved collection 1976-02-19 Approved with change
197601-3220-001 Extension without change of a currently approved collection 1976-01-30 Approved without change