OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Statement of Claimant or Other Person

OMB 3220-0183 · 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 can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form
Form
Supporting Statement A
All Historical Document Collections
 Extension without change of a currently approved collection 2025-06-23
Approved without change
 Extension without change of a currently approved collection 2022-04-28
Approved without change
 Revision of a currently approved collection 2019-03-21
Approved without change
 Extension without change of a currently approved collection 2015-10-09
Approved without change
 Extension without change of a currently approved collection 2012-09-19
Approved without change
 Extension without change of a currently approved collection 2009-07-17
Approved without change
 Extension without change of a currently approved collection 2006-05-31
Approved without change
 Extension without change of a currently approved collection 2003-07-22
Approved without change
 Extension without change of a currently approved collection 2000-09-05
Approved without change
 Revision of a currently approved collection 1997-10-08
Approved without change
 Revision of a currently approved collection 1994-10-31
Approved without change
 New collection (Request for a new OMB Control Number) 1991-08-16