Application to Act as Representative Payee

ICR 201608-3220-001

OMB: 3220-0052

Federal Form Document

ICR Details
3220-0052 201608-3220-001
Historical Active 201308-3220-001
RRB
Application to Act as Representative Payee
Revision of a currently approved collection   No
Regular
Approved without change 12/12/2016
Retrieve Notice of Action (NOA) 10/26/2016
  Inventory as of this Action Requested Previously Approved
12/31/2019 36 Months From Approved 12/31/2016
20,300 0 20,300
16,350 0 16,350
0 0 0

Under Section 12 of the Railroad Retirement Act, the Railroad Retirement Board (RRB) may pay benefits to a representative payee when an employee, spouse or survivor annuitant is incompetent or is a minor. The collection obtains information related to the representative payee application, supporting documentation and the maintenance of records pertaining to the receipt and use of benefits.

US Code: 45 USC 231k Name of Law: Railroad Retirement Act
   US Code: 45 USC 231f Name of Law: Railroad Retirement Act
  
None

Not associated with rulemaking

  81 FR 54856 08/17/2016
81 FR 73156 10/24/2016
No

  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 20,300 20,300 0 0 0 0
Annual Time Burden (Hours) 16,350 16,350 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
Yes
No
No
No
Uncollected
Charles Mierzwa 312-751-3363 charles.mierzwa@rrb.gov

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/26/2016


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