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Referral Card - Report On Placement Or Refusal Of Referral Or Offer To Railroad Retirement Board
REFERRAL CARD - REPORT ON PLACEMENT OR REFUSAL OF REFERRAL OR OFFER TO RAILROAD RETIREMENT BOARD
OMB: 3220-0027
IC ID: 176920
OMB.report
RRB
OMB 3220-0027
ICR 198104-3220-007
IC 176920
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
REFERRAL CARD - REPORT ON PLACEMENT OR REFUSAL OF REFERRAL OR OFFER TO RAILROAD RETIREMENT BOARD
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
ES-21 &
No
No
Form
ES-21C
No
No
Form
ES-21,
No
No
Form
ES-21C
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
21,000
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
26,000
0
5,000
0
0
21,000
Annual IC Time Burden (Hours)
883
0
0
0
0
883
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.