Statement of Claimant or Other Person

OMB 3220-0183

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 2022-05-31 and can be found here.

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Statement of Claimant or Other Person

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form G-93 (09-18)Statement of Claimant or Other PersonPaper OnlyForm

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