Job Information Report

Forms and Documents

Document Name	Status
Form G-251A Job Information Report Form and Instruction	Modified
Form G-251B (11-00).pdf Supplementary Document	2016-06-30
Form G-251A (11-00).pdf Supplementary Document	2016-06-30
3220-0193.doc Supporting Statement A	2016-06-30

IC Document Collections

IC ID	Document Title	Status
34010	Job Information Report Form and Instruction	Modified

ICR Details

OMB Control No: 3220-0193	ICR Reference No: 201606-3220-001
Status: Historical Active	Previous ICR Reference No: 201304-3220-002
Agency/Subagency: RRB	Agency Tracking No:
Title: Job Information Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 07/15/2016
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/12/2016
	Date Received in OIRA: 06/30/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	6 Months From Approved	12/31/2016
Responses	500	0	430
Time Burden (Hours)	500	0	144
Cost Burden (Dollars)	0	0	0

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Abstract: The collection obtains information used by the Railroad Retirement Board (RRB) to assist in determining whether a railroad employee is disabled from his or her regular occupation. It provides, under certain conditions, railroad employers with the opportunity to provide information to the RRB regarding the employee applicant's job duties.

Emergency Justfication: Changes are being proposed to Form G-251a in support of the RRB’s Disability Program Improvement Project (DPIP) to enhance/improve disability case processing and overall program integrity. Disability case processing and related program integrity issues have been the topic of RRB’s Office of Inspector General and the Government Accountability Office recommendations, as well as a 2015 Congressional Hearing by the House Committee on Oversight and Government Reform and the RRB has been tasked with reporting progress periodically to Senate and House committees. After a long and thorough review and evaluation, the RRB is now ready to go forward with significant revisions of this information collection.

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Authorizing Statute(s): US Code: 45 USC 231a Name of Law: Railroad Retirement Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 25724	04/29/2016
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Job Information Report	G-251A	Railroad Job Information

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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	500	430	0	0	70	0
Annual Time Burden (Hours)	500	144	0	0	356	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: We propose to obsolete current Forms G-251A and Form G-251B and remove them from the collection. We propose that the annual responses for new Form G-251A will be 500, it will take 60 minutes to complete the form, and the total burden hours will be 500. This change increases the collection’s annual responses by 70 from the previous 430 for the combined G-251A and G-251B, to the proposed 500 for the new G-251A; the completion time increases by 40 minutes, from 20 minutes to 60 minutes as the new Form G-251a requests significantly more information and the burden hours increase by 356, from 144 to 500. We are showing the increase as an adjustment

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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)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 06/30/2016

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