OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Repayment of Debt

OMB 3220-0169 ยท RRB.

OMB 3220-0169

When the RRB determines that an overpayment of benefits under the Railroad Retirement Act or Railroad Unemployment Insurance Act has occurred, it initiates prompt action to notify the claimant of the overpayment and to recover the amount owed. The collection obtains information needed to allow for repayment by the claimant by credit card, in addition to the customary form of payment by check or money order.

The latest form for Repayment of Debt expires 2026-07-31 and is listed under ICR 202303-3220-005.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form G-421F (04-20) Repayment by Credit Card - CurrentForm
Form G-421F (04-20) Repayment by Debit Card - (Current)Form
3220-0169_Final.docxSupporting Statement A
Form DRL-145 (12-17).pdfSupplementary Document
Form DR-422B (02-18).pdfSupplementary Document
Form DR-422A (02-18).pdfSupplementary Document
Form DRL-145 (07-16).pdfSupplementary Document
Form SSA-714 (07-05).pdfSupplementary Document
Form G-66BA (03-13).pdfSupplementary Document
DR-422C (09-19).pdfSupplementary Document
Form G-421 (02-18).pdfSupplementary Document
G-66B (02-03).pdfSupplementary Document
G-66 (02-03).pdfSupplementary Document
Form G-66A (03-13).pdfSupplementary Document
Repayment by Credit Card Form
Repayment by Credit Card Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202507-3220-007 Extension without change of a currently approved collection 2026-06-01
202303-3220-005 Extension without change of a currently approved collection 2023-03-28 Approved without change
201912-3220-005 Revision of a currently approved collection 2019-12-30 Approved with change
201712-3220-001 No material or nonsubstantive change to a currently approved collection 2017-12-28 Approved without change
201606-3220-002 Extension without change of a currently approved collection 2016-08-22 Approved without change
201304-3220-001 Revision of a currently approved collection 2013-04-26 Approved without change
200912-3220-001 Revision of a currently approved collection 2009-12-28 Approved without change
200609-3220-001 Extension without change of a currently approved collection 2006-09-29 Approved without change
200307-3220-001 Extension without change of a currently approved collection 2003-07-15 Approved without change
200005-3220-001 Extension without change of a currently approved collection 2000-05-02 Approved without change
199701-3220-001 Extension without change of a currently approved collection 1997-01-14 Approved without change
199601-3220-001 Extension without change of a currently approved collection 1996-01-26 Approved without change
199509-3220-002 No material or nonsubstantive change to a currently approved collection 1995-09-30 Approved without change
199209-3220-002 Revision of a currently approved collection 1992-09-01 Approved without change
198905-3220-004 New collection (Request for a new OMB Control Number) 1989-05-09 Approved without change

OMB Details

Repayment by Credit Card

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Information collection instruments
FormNameElectronic accessType
Form G-421F (04-20)Repayment by Debit Card - (Current)Paper OnlyForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.