Railroad Separation Allowance or Severance Pay Report

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0173 can be found here:

Documents and Forms

Document Name Document Type
Form BA-9 (10-15) Railroad Separation Allowance or Severance Pay Report Form and Instruction
BA-9 Instructions (Electronic Format).pdf www.rrb.gov/sites/default/files/2017-06/RERI-App.%20I_Form%20BA-9.pdf Instruction
BA-9 (10-15) Report of Separation Allowance or Severance Pay Form BA-9 (10-15).pdf www.rrb.gov/sites/default/files/2018-07/BA-9.pdf Form and Instruction
BA-9 (secure E-mai Report of Separation Allowance or Severance Pay Report Program Letter 2008-05 (secure E-mail and FTP).pdf www.rrb.gov/sites/default/files/2018-03/PL%2008-05.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Railroad Separation Allowance or Severance Pay Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 209.14

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BA-9 (10-15)	Report of Separation Allowance or Severance Pay	Form BA-9 (10-15).pdf	https://www.rrb.gov/sites/default/files/2018-07/BA-9.pdf	Yes	No	Printable Only
Instruction			BA-9 Instructions (Electronic Format).pdf	https://www.rrb.gov/sites/default/files/2017-06/RERI-App.%20I_Form%20BA-9.pdf	Yes	No	Printable Only
Form and Instruction	BA-9 (secure E-mail - File Transfer Protocol)	Report of Separation Allowance or Severance Pay Report	Program Letter 2008-05 (secure E-mail and FTP).pdf	https://www.rrb.gov/sites/default/files/2018-03/PL%2008-05.pdf	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: RRB-5; Master File of Railroad Employee's Creditable Compensation	FR Citation: 79 FR 58874

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 72 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	360	0	360
Annual IC Time Burden (Hours)	457	218	239
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.