OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Statement of Authority to Act for Employee

OMB 3220-0034 · RRB.

OMB 3220-0034

Under 20 CFR 335.2, the Railroad Retirement Board (RRB) accepts claims for sickness benefits by other than the sick or injured employees, provided the RRB has the information needed to satisfy itself that the delegation should be made.

The latest form for Statement of Authority to Act for Employee expires 2027-08-31 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form
Supporting Statement A
All Historical Document Collections
 Revision of a currently approved collection 2024-06-27
Extension without change of a currently approved collection 2020-12-10
Approved without change
 Extension without change of a currently approved collection 2017-10-20
Approved without change
 Extension without change of a currently approved collection 2014-08-20
Approved without change
 Extension without change of a currently approved collection 2011-07-21
Approved without change
 Extension without change of a currently approved collection 2008-05-29
Approved without change
 Extension without change of a currently approved collection 2005-05-26
Approved without change
 Extension without change of a currently approved collection 2002-07-15
Approved without change
 Extension without change of a currently approved collection 1999-09-30
Approved without change
 Extension without change of a currently approved collection 1996-10-31
Approved without change
 Extension without change of a currently approved collection 1993-10-15
Approved without change
 Revision of a currently approved collection 1990-10-29
Approved without change
 Extension without change of a currently approved collection 1987-07-09
Approved without change
 Extension without change of a currently approved collection 1984-09-25
Approved without change
 Extension without change of a currently approved collection 1981-09-24
Approved with change
 No material or nonsubstantive change to a currently approved collection 1981-05-28
Approved with change
 No material or nonsubstantive change to a currently approved collection 1981-03-21
Approved without change
 Reinstatement with change of a previously approved collection 1981-02-19
Approved with change
 No material or nonsubstantive change to a currently approved collection 1980-10-28
Approved with change
 No material or nonsubstantive change to a currently approved collection 1980-03-25
Approved without change
 Revision of a currently approved collection 1979-09-28
Approved with change
 No material or nonsubstantive change to a currently approved collection 1979-07-18
Approved without change
 Extension without change of a currently approved collection 1978-08-30