Financial Disclosure Statement

OMB 3220-0127

Under the Railroad Retirement and the Railroad Unemployment Insurance Acts, the Railroad Retirement Board has authority to secure from an overpaid beneficiary a statement of the individual's assets and liabilities if waiver of the overpayment is requested.

The latest form for Financial Disclosure Statement expires 2021-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form DR-423 (04-17) Financial Disclosure Statement Form and Instruction
3220-0127.docx Supporting Statement A
Financial Disclosure Statement Form and Instruction

All Historical Document Collections

202011-3220-004	Extension without change of a currently approved collection	2020-11-24
201708-3220-001 Approved without change	Extension without change of a currently approved collection	2017-08-29
201406-3220-002 Approved without change	Extension without change of a currently approved collection	2014-07-15
201104-3220-002 Approved without change	Extension without change of a currently approved collection	2011-06-09
200801-3220-001 Approved without change	Revision of a currently approved collection	2008-01-28
200501-3220-001 Approved without change	Revision of a currently approved collection	2005-01-21
200203-3220-005 Approved without change	Extension without change of a currently approved collection	2002-03-29
199906-3220-003 Approved without change	No material or nonsubstantive change to a currently approved collection	1999-06-02
199904-3220-001 Approved without change	Extension without change of a currently approved collection	1999-04-05
199604-3220-004 Approved without change	Revision of a currently approved collection	1996-04-30
199509-3220-006 Approved without change	No material or nonsubstantive change to a currently approved collection	1995-09-30
199212-3220-003 Approved without change	Revision of a currently approved collection	1992-12-30
198910-3220-001 Approved without change	Revision of a currently approved collection	1989-10-24
198610-3220-001 Approved without change	Revision of a currently approved collection	1986-10-21
198604-3220-002 Approved without change	Revision of a currently approved collection	1986-04-24
198507-3220-003 Approved without change	Extension without change of a currently approved collection	1985-07-30
198206-3220-001 Approved without change	Extension without change of a currently approved collection	1982-06-07
198106-3220-001 Approved without change	New collection (Request for a new OMB Control Number)	1981-06-17