Evidence of Marital Relationship - Living with Requirements

ICR 201912-3220-001

OMB: 3220-0021

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2019-12-23
IC Document Collections
ICR Details
3220-0021 201912-3220-001
Active 201605-3220-002
RRB
Evidence of Marital Relationship - Living with Requirements
Revision of a currently approved collection   No
Regular
Approved without change 03/26/2020
Retrieve Notice of Action (NOA) 12/23/2019
Upon resubmission, the agency shall reevaluate the burden of this collection to ensure it is fully accounted. The agency shall also evaluate potential for the collection to be electronic.
  Inventory as of this Action Requested Previously Approved
03/31/2023 36 Months From Approved 03/31/2020
1,100 0 1,100
196 0 196
0 0 0

Under the RRA, to obtain a benefit as a spouse of an employee annuitant or as the widow(er) of the deceased employee, an applicant must submit information to be used to determine if the marriage requirements for such benefits have been met. The collection obtains information supporting claimed common-law marriage, termination of previous marriages, and residency requirements.

US Code: 45 USC 231(a) Name of Law: Railroad Retirement Act
  
None

Not associated with rulemaking

  84 FR 48381 09/13/2019
84 FR 64938 11/25/2019
No

1
IC Title Form No. Form Name
Evidence of Marital Relationship - Living with Requirements G-238A (Proposed), G-124A (05-08), G-237 (05-08), G-238 (10-02), G-238A (10-02), G-124 (Proposed), G-124A (Proposed), G-237 (Proposed), G-238 (Proposed), G-124 (05-08) Statement of Marital Relationship ,   Statement Regarding Marriage ,   Statement Regarding Marital Status ,   Statement Regarding Divorce or Annulment ,   Statement of Residence ,   Statement of Marital Relationship ,   Statement Regarding Marriage ,   Statement Regarding Marital Status ,   Statement of Residence ,   Statement Regarding Divorce or Annulment

  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 1,100 1,100 0 0 0 0
Annual Time Burden (Hours) 196 196 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.
12/23/2019


© 2024 OMB.report | Privacy Policy