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Federal forms, ICRs, and supporting documents

OMB control number

Statement Regarding Contributions and Support

OMB 3220-0099 ยท RRB.

OMB 3220-0099

Dependency on the employee for one-half support at the time of the employee's death can be a condition affecting eligibility for a survivor annuity provided for under Section 2 of the Railroad Retirement Act. One-half support is also a condition which may negate the public service pension offset in Tier I for a spouse or widow(er).

The latest form for Statement Regarding Contributions and Support expires 2027-07-31 and is listed under ICR 202405-3220-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form G-134 Statement Regarding Contributions and SupportForm
3220-0099.docxSupporting Statement A
Statement Regarding Contributions and Support Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202405-3220-001 Revision of a currently approved collection 2024-05-21
202011-3220-003 Revision of a currently approved collection 2020-11-24
201709-3220-005 Extension without change of a currently approved collection 2017-09-20 Approved without change
201407-3220-006 Extension without change of a currently approved collection 2014-08-05 Approved without change
201107-3220-003 Extension without change of a currently approved collection 2011-07-21 Approved without change
200803-3220-002 Extension without change of a currently approved collection 2008-05-23 Approved without change
200505-3220-002 Extension without change of a currently approved collection 2005-05-26 Approved without change
200204-3220-002 Extension without change of a currently approved collection 2002-04-26 Approved without change
199904-3220-002 Revision of a currently approved collection 1999-04-19 Approved without change
199902-3220-001 No material or nonsubstantive change to a currently approved collection 1999-02-23 Approved without change
199512-3220-001 Extension without change of a currently approved collection 1995-12-29 Approved without change
199509-3220-001 No material or nonsubstantive change to a currently approved collection 1995-09-30 Approved without change
199209-3220-003 Extension without change of a currently approved collection 1992-09-24 Approved without change
198907-3220-005 Extension without change of a currently approved collection 1989-07-31 Approved without change
198904-3220-011 No material or nonsubstantive change to a currently approved collection 1989-04-07 Approved with change
198904-3220-006 No material or nonsubstantive change to a currently approved collection 1989-04-04 Approved with change
198607-3220-003 Extension without change of a currently approved collection 1986-07-23 Approved without change
198308-3220-004 Revision of a currently approved collection 1983-08-17 Approved without change
198105-3220-023 No material or nonsubstantive change to a currently approved collection 1981-05-28 Approved with change
198005-3220-005 Revision of a currently approved collection 1980-05-28 Approved without change
197904-3220-006 Extension without change of a currently approved collection 1979-04-27 Approved without change
197903-3220-008 Extension without change of a currently approved collection 1979-03-14 Approved without change
197803-3220-014 Extension without change of a currently approved collection 1978-03-31 Approved without change
197803-3220-013 Extension without change of a currently approved collection 1978-03-06 Approved without change