REQUEST FOR INFORMATION AND STATEMENT OF MARITAL STATUS (LEGAL TERMINATION OF PREVIOUS MARRIAGE)

ICR 197704-3220-004

OMB: 3220-0063

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
3220-0063 197704-3220-004
Historical Active 197504-3220-013
RRB
REQUEST FOR INFORMATION AND STATEMENT OF MARITAL STATUS (LEGAL TERMINATION OF PREVIOUS MARRIAGE)
Extension without change of a currently approved collection   No
Regular
Approved without change 05/03/1977
Retrieve Notice of Action (NOA) 04/26/1977
  Inventory as of this Action Requested Previously Approved
04/30/1982 04/30/1982 06/30/1977
500 0 500
250 0 250
0 0 0

TO OBTAIN BENEFITS UNDER SECTION 2 OF THE RAILROAD RETIREMENT ACT, THE SPOUSE OF A RETIRED ANNUITANT OR THE WIDOW(ER) OF A DECEASED EMPLOYEE WITH MORE THAN ONE MARRIAGE, MUST SUBMIT PROOF OF TERMINATION OF A PREVIOUS MARRIAGE OF EITHER SPOUSE. THE STATEMENTS WILL OBTAIN INFORMATION NEEDED TO DETERMINE IF THE APPLICANT MEETS THE MARITAL STATUS REQUIREMENTS FOR ENTITLEMENT TO THE BENEFITS APPLIED FOR

None
None


No

1
IC Title Form No. Form Name
REQUEST FOR INFORMATION AND STATEMENT OF MARITAL STATUS (LEGAL TERMINATION OF PREVIOUS MARRIAGE) G-237, G-237A

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 500 500 0 0 0 0
Annual Time Burden (Hours) 250 250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/26/1977


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