ID-5S (10-07) ID-5S(SUP) Transmittal Letter

FORM APPROVED
OMB NO 3220-0196
U.S. RAILROAD RETIREMENT BOARD
OFFICE OF PROGRAMS - ASSESSMENT AND TRAINING
P.O. BOX 10695
CHICAGO, IL 60610-0695

ER NUMBER

A comparison of unemployment and sickness benefit payment records with
railroad compensation adjustment reports shows the employees on the
enclosed listing were paid unemployment and/or sickness benefits for every
day in one or more months for which a service month was sUbsequently
credited. To determine if the 'service month(s) credited affects the payment
of benefits for the fully claimed months, we need addit~ohal information
from you.
Please advise us of t,ne type of compensation each, of your employees
received for the month(s) shown and the 'exact days forwhichtl1e payment
When more than one month is list;ed, be sure to specify tHe type
of compensation reported for each mon,th. If the employee received sick pay,
indicate the agreement under under Which the payment was made. In addition,
read and complete the Employer Certification statement ahd provide us With
the name and telephone number of the ,official to contact if we have
questions concerning the information.
If, after you review your payroll records, you determine that one or more
months of creditable service was incorrectly reported, complete Form BA-4,
Report of Creditable Compensation Adjustments, to reVise. or delete the
month(s) credited in error. Include the completed
Forni BA-4 with the
'\
enclosed listing after you have furnished the information according to the
instructions provided on this page. If you complete the Form BA-4 online
through the Employer Reporting system, notate nERs n next to the employer
name on the enclosed listing.
Our authority for requesting this information is explained on the reverse
side of this letter. If you have any questions about this request, please
contact us at (312) 751-4805. Thank you for your cooperation.
Railroad Retirement Board
Enclosure

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rD-5S (10-07)

ID-5S (l0-07)
PAPERWORK REDUCTION ACT/PRIVACY ACT NOTICES
We estimate that a response to Form ID-5S (Sup) takes an average of 10
minutes to complete, including the time for reviewing the instructions,
getting the needed data, and reviewing the completed response. 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 tim€, to Chief of Information Resources Management Railroad
Retirement Board, 844 N. Rush Street, Chicago, IL 60611-2092.
The Railroad Retirement Board's (RRB) authority for requesting information
is contained in sections 5(b), 9(2), and.12(a) of :the Railrqad Unemployment
Insurance Act (RUIA). Although the RUIA gives the RRB the authority to
compel disclosur,e thro:ugh use of the subpoena, the RRB's experience has been that
employers voluntarily release earnings information when they know that the
RRB uses that information for the limited purpose of verifying a claim for
benefits.
The RRB realizes that. many c~mpanies have adopted policies regarding
disclosures of personal information needed for proper auministration Of the
Railroad Unemployment Insurance Act. Information that the RRB acquires
about a person is pq)tected from disclosure except as pro,?ided bylaw.