OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Statement of Claimant or Other Person

OMB 3220-0183 ยท RRB.

OMB 3220-0183

Under Section 2 of the Railroad Retirement Act and the Railroad Unemployment Insurance Act, pertinent information and proofs must be submitted by an applicant so that the Railroad Retirement Board can determine his or her entitlement to benefits. The collection obtains information supplementing or changing information previously provided by an applicant.

The latest form for Statement of Claimant or Other Person expires 2028-07-31 and is listed under ICR 202504-3220-021.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form G-93 (09-18) Statement of Claimant or Other PersonForm
Form G-93 (09-18) Statement of Claimant or Other PersonForm
3220-0183_Final.docxSupporting Statement A
Statement of Claimant or Other Person Form
Statement of Claimant or Other Person Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202504-3220-021 Extension without change of a currently approved collection 2025-06-23
202204-3220-004 Extension without change of a currently approved collection 2022-04-28 Approved without change
201903-3220-001 Revision of a currently approved collection 2019-03-21 Approved without change
201509-3220-002 Extension without change of a currently approved collection 2015-10-09 Approved without change
201208-3220-003 Extension without change of a currently approved collection 2012-09-19 Approved without change
200907-3220-001 Extension without change of a currently approved collection 2009-07-17 Approved without change
200605-3220-002 Extension without change of a currently approved collection 2006-05-31 Approved without change
200307-3220-002 Extension without change of a currently approved collection 2003-07-22 Approved without change
200009-3220-001 Extension without change of a currently approved collection 2000-09-05 Approved without change
199710-3220-001 Revision of a currently approved collection 1997-10-08 Approved without change
199410-3220-002 Revision of a currently approved collection 1994-10-31 Approved without change
199108-3220-003 New collection (Request for a new OMB Control Number) 1991-08-16 Approved without change