RUIA Claims Notification and Verification System

Forms and Documents

Document Name	Status
Form ID-4E RUIA Claims Notification System Form	Modified
3220-0171.docx Supporting Statement A	2014-12-19
Form BA-12 (10-14).pdf Supplementary Document	2014-12-10
ERS Outstanding Items List (02-09).pdf Supplementary Document	2014-12-02
ERS Log on Screen (08-05).pdf Supplementary Document	2014-12-02
ERS Entry Screen (08-05).pdf Supplementary Document	2014-12-02
Circular Letter UIC 229 (09-14).pdf Supplementary Document	2014-11-20
Form BA-12 (05-09).pdf Supplementary Document	2014-12-10

IC Document Collections

IC ID	Document Title	Status
33972	RUIA Claims Notification System Form	Modified

ICR Details

OMB Control No: 3220-0171	ICR Reference No: 201411-3220-001
Status: Historical Active	Previous ICR Reference No: 201111-3220-001
Agency/Subagency: RRB	Agency Tracking No:
Title: RUIA Claims Notification and Verification System
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/06/2015
	Date Received in OIRA: 12/19/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2018	36 Months From Approved	01/31/2015
Responses	75,920	0	77,935
Time Burden (Hours)	2,158	0	2,001
Cost Burden (Dollars)	0	0	0

---

Abstract: Section 5(b) of the RUIA requires that effective January 1, 1990, when a claim for benefits is filed with the Railroad Retirement Board (RRB), the RRB shall provide notice of such claim to the claimant's base-year employer(s) and afford such employer(s) an opportunity to submit information relevant to the claim before making an initial determination on the claim. When the RRB determines to pay benefits to a claimant under the RUIA, the RRB shall provide notice of such determination to the claimant's base-year employer.

---

Authorizing Statute(s): US Code: 45 USC 362(l) Name of Law: Railroad Unemployment Insurance Act
   US Code: 45 USC 355 Name of Law: Railroad Unemployment Insurance Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 57988	09/26/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 72035	12/04/2014
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
RUIA Claims Notification System	ID-4K (Internet), ID-4E, ID-4E (Internet), ID-4K	Notice of RUIA Claim Determination ,   Notice of RUIA Claim Determination ,   Prepayment Notice of Employees' Applications and Claims for Benefits Under the RUIA ,   Prepayment Notice of Employees' Applications and Claims for Benefits Under the RUIA

---

ICR Summary of Burden

	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	75,920	77,935	0	0	-2,015	0
Annual Time Burden (Hours)	2,158	2,001	0	0	157	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Yes

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/19/2014

---