Annual Earnings Questionnaire for Annuitants in Last Pre-Retirement Non-Railroad Employment

ICR 201805-3220-002

OMB: 3220-0179

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2018-05-23
Supplementary Document
2018-05-18
IC Document Collections
ICR Details
3220-0179 201805-3220-002
Active 201502-3220-003
RRB
Annual Earnings Questionnaire for Annuitants in Last Pre-Retirement Non-Railroad Employment
Extension without change of a currently approved collection   No
Regular
Approved without change 07/09/2018
Retrieve Notice of Action (NOA) 05/23/2018
  Inventory as of this Action Requested Previously Approved
07/31/2021 36 Months From Approved 07/31/2018
300 0 300
75 0 75
0 0 0

Under Section 2(e)(3) of the Railroad Retirement Act, an annuity is not payable or is reduced for any month in which the beneficiary works for a railroad or earns more than the prescribed amounts. The collection obtains earnings information needed by the Railroad Retirement Board to determine possible reductions in annuities because of earnings.

US Code: 45 USC 231(a) Name of Law: Railroad Retirement Act
   US Code: 45 USC 231(f) Name of Law: Railroad Retirement Act
   PL: Pub.L. 100 - 647 7303 Name of Law: Technical and Miscellaneous Revenue Act of 1988
  
None

Not associated with rulemaking

  83 FR 7511 02/21/2018
83 FR 20872 05/08/2018
No

1
IC Title Form No. Form Name
Annual Earnings Questionnaire for Annuitants in Last Pre-Retirement Non-Railroad Employment G-19L Annual Earnings Questionnaire

  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 300 300 0 0 0 0
Annual Time Burden (Hours) 75 75 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
Uncollected
Brian Foster 312 751-4826 brian.foster@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.
05/23/2018


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