Form G-88P Employer's Supplemental Pension Report

United States o f America
Railroad Retirement Board

Form Approved
OMB NO.3220-0089

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SECTION 1 IDEN'I'IFYING INFORMATION
1 Social Securitv No.

Employer's Supplemental
Pension Report
2

1

Railr'oad Contact Official's Name and Address

I

3 Name

4 Date Released

5 BA No.

,

I
6 Job Title or Category
Salaried
Non-Agreement
Agreement (Union)
Other
7 The RRB completes this item when our records indicate that the railroad pension paid by you is reduced for the RRB annuity.
This annuity rate is based on earnings through the year
and
months of creditable railroad service.
The current monthly Tier I rate is $
and the current monthly Tier II rate is $
.
The RRB SLIP ANN rate before reduction for an employer pension is $
.
SECTION 2 EMPLOYER ENTRIES
lnstructions for completing this form are in the Reporting Instructions to Employers. Also read "Important Notices" on the next page.
8 Is the employee, or will the employee be, entitled to a pension (or lump-sum
Yes - Go to ltem 9
payment in lieu of pension) from your railroad that is approved by the RRB
No - Go to Item 19
because it is based, in whole or in part, on employer contributions?
9 Enter the name of the pension plan(s).
Pension 1
Note: I f the employee is covered under
+
more than one pension, enter the
pension names under "Pension I "
and "Pension 2. "
Yes
10 Has the employee filed for any pension named in Item 9?
No -Retain a copy of this form to report when the employee
files for the pension.
11 Did, or will, the employee receive the pension in one or more lump-sum payments at or
Yes - Go to Item Il a
after attainment of the retirement age indicated in the pension plan?
No - Go to Item 12
a.
CTotal
Amount
of
Lump
Sum,
d.
Total Amount of Lump Sum,
3. Date AII or part of ~ u m p
Excluding
Employee Contributions
Pension
Including
Employee
Contributions
Sum waslwill be Paid
to Pension Plan
to Pension Plan
Number
MM
DD
CCW
(Leave Items 17a & b blank)
(Also complete Items 17a & b)
1
Fax No.:

-

+

+

+

2
12 Is any pension named in Item 9 payable as a monthly pension?
Note: I f a lump-sum had been elected in lieu of the monthly pension,
answer this item "Yes. "
13 Enter the beginning date of the monthly pension rate(s). If the pension has not
yet begun, enter the estimated date that the pension will begin.
Note: I f a lump-sum has been elected in lieu of the monthly pension,
enter the earliest date the monthly pension could have begun.
14 Is any monthly pension named in Item 9 reduced by the amount of the RRB
SUP ANN?
15 Do either of the following
- auulv?
.. The monthly pension rate includes employee contributions.
The net monthly pension rate(s) payable is less than $43.00.
Note: I f a lump-sum was elected in lieu of the monthly pension, answer
this item based on the monthly rate that would have been payable.
16 Enter the monthly pension rate information requested below.

LEEE

P'

Gross Monthly Pension Rate

'1

+

+
+

+

Monthly Reduction for
Joint and Survivor Option

17 Did the employee make contributions to the pension account that have been
included in the amount of the lump-sum payment reported in ltem Il c or in the
calculation of the monthlv ensi ion rate entered in Item 16b?

yes - GOto ltem 13
No - Go to ltem 17
Beginning Date
Pension
Number
MM I DD I CCYY
1
2
Yes - Go to Item 19
IDNO-~otoltem15
Yes - Go to ltem 16
No - Go to ltem 19

Monthly Reduction
for Early Retirement

+

Yes - Go to ltem 17a
No-Gotoltem19

I

a. Indicate the basis of the lump-sum or monthly pension payment.

Paid based on age
Paid based on disability

b. Furnish the amount of the employee's contributions for the years listed below.
Note: List all employee contributions next to the year they were made. Include any amount withheld from the employee's
pay, any contributions made by your company in lieu of a pay increase under the provision of a collective bargaining
agreement, and any amounts rolled over to this plan by the employee from another pension account. Do nof include any
contributions withdrawn or refunded.
Employee
Employee
Employee
Employee
Contributions
Contributions
Year
Year
Contributions
Year
Year
Contributions
Amount
Amount
Amount
Amount
1955-1959 $
2000 $
1978 $
1989 $
1960-1962 $
1963-1965 $

1979

$

1990

$

2001

$

1980

$

1991

$

2002

$

1966-1968

$

1981

$

1992

$

2003

$

1969-1971

$

1982

$

1993

$

2004

$

1972

$

1983

$

1994

$

2005

$

1973

$

1984

$

1995

$

2006

$

1974

$

1985

$

1996

$

2007

$

1975

$

1986

$

1997

$

2008

$

1976

$

1987

$

1998

$

2009

$

18 Remarks - Use this item to include any additional information.

19 Employer Certification by Railroad Supplemental Annuity Contact Official -Always complete this item.
I certify that I have examined this report, that it is made in good faith and that to the best of my knowledge and belief all entries
made herein are true and correct, and in accordance with the laws and regulations applicable hereto. I understand that
providing false or fraudulent information or failing to provide required information is a violation of federal law punishable by fine,
imprisonment or both.

Signature of RR Contact Official
Business Telephone Number with area code

Title

(

)

Date
DO NOT WRITE IN THIS AREA

Return this form to:
US Railroad Retirement Board
844 N Rush Street, RBD-RIS
Chicago, IL 60611-2092
Fax Number (312) 751-7192

-- FOR RRB USE ONLY

Date Reply Received at RRB
Received By

IMPORTANT NOTICES
PAPERWORK REDUCTION ACT NOTICE
The information requested on this form is needed to determine if a reduction is required to the supplemental annuities of your retired
employees under Section 2(h) (2) of the Railroad Retirement Act (RRA) (45 USC 231a(h)(2)). Furnishing this information is required
by law, (Section 7(b)(6) of the RRA (45 USC 231f(b)(6))).
We estimate this form takes an average of 8 minutes to complete, including the time for reviewing the instructions, getting the
needed data, and reviewing the completed form. Federal agencies may not conduct or sponsor, and respondents are not required to
respond to, a collection of information unless it displays a valid OMB number. If you wish, send comments regarding the accuracy of
our estimate or any other aspect of this form, including suggestions for reducing completion time, to Chief of Information Resources
Management, Railroad Retirement Board, 844 N. Rush St, Chicago, Illinois 60611-2092.