OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Application for Benefits Due but Unpaid at Death

OMB 3220-0055 ยท RRB.

OMB 3220-0055

The collection obtains the information needed by the Railroad Retirement Board to pay benefits accrued under section 2(g) of the Railroad Unemployment Insurance Act, but not paid because of the death of the employee.

The latest form for Application for Benefits Due but Unpaid at Death expires 2028-07-31 and is listed under ICR 202504-3220-017.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form Form UI-63 (XX-XX) Application for Benefits Due But Unpaid at DeathForm and Instruction
Form UI-63 (01-18) Application for Benefits Due But Unpaid at DeathForm and Instruction
Form UI-63 (01-18) Application for Benefits Due but Unpaid at DeathForm and Instruction
3220-0055_Final.docxSupporting Statement A
Application for Benefits Due but Unpaid at Death Form and Instruction
Application for Benefits Due but Unpaid at Death Form and Instruction
Application for Benefits Due but Unpaid at Death Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202504-3220-017 Reinstatement with change of a previously approved collection 2025-06-13
202106-3220-002 Extension without change of a currently approved collection 2021-06-30 Approved without change
201804-3220-001 Revision of a currently approved collection 2018-04-13 Approved without change
201501-3220-001 Extension without change of a currently approved collection 2015-01-30 Approved without change
201112-3220-001 Extension without change of a currently approved collection 2012-01-23 Approved without change
200810-3220-003 Revision of a currently approved collection 2008-12-22 Approved without change
200510-3220-003 Extension without change of a currently approved collection 2005-10-25 Approved without change
200210-3220-003 Extension without change of a currently approved collection 2002-10-10 Approved without change
200001-3220-002 Extension without change of a currently approved collection 2000-01-18 Approved without change
199703-3220-002 Extension without change of a currently approved collection 1997-03-10 Approved without change
199402-3220-001 Revision of a currently approved collection 1994-02-16 Approved without change
199104-3220-003 No material or nonsubstantive change to a currently approved collection 1991-04-09 Approved with change
199011-3220-002 Revision of a currently approved collection 1990-11-29 Approved without change
198708-3220-003 Extension without change of a currently approved collection 1987-08-31 Approved without change
198512-3220-002 No material or nonsubstantive change to a currently approved collection 1985-12-20 Approved with change
198411-3220-002 No material or nonsubstantive change to a currently approved collection 1984-11-13 Approved with change
198409-3220-002 Revision of a currently approved collection 1984-09-26 Approved without change
198109-3220-003 Extension without change of a currently approved collection 1981-09-25 Approved without change
198105-3220-011 No material or nonsubstantive change to a currently approved collection 1981-05-28 Approved with change
198005-3220-007 Extension without change of a currently approved collection 1980-05-01 Approved without change
197904-3220-008 Extension without change of a currently approved collection 1979-04-27 Approved without change
197903-3220-012 Extension without change of a currently approved collection 1979-03-14 Approved without change
197402-3220-002 New collection (Request for a new OMB Control Number) 1974-02-14 Approved without change