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Public Service Pension Questionnaires
Public Service Pension Questionnaires
OMB: 3220-0136
IC ID: 33931
OMB.report
RRB
OMB 3220-0136
ICR 202006-3220-003
IC 33931
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0136 can be found here:
2023-03-28 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form G-208 (02-17)
Public Service Pension Questionnaires
Form
G-208 (02-17) Public Service Pension Questionnaire
Form G-208 (02-17).pdf
Form
G-212 (02-17) Public Service Pension Monitoring Questionnaire
Form G-212 (02-17).pdf
Form
Form SSA-3885 (02-18).pdf
SSA-3885
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Public Service Pension Questionnaires
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 219.64(c)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
G-208 (02-17)
Public Service Pension Questionnaire
Form G-208 (02-17).pdf
No
Paper Only
Form
G-212 (02-17)
Public Service Pension Monitoring Questionnaire
Form G-212 (02-17).pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
RRB-22, Railroad Retirement, Survivor and Pensioner Benefit System
FR Citation:
79 FR 58874
Number of Respondents:
1,170
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,170
0
0
0
0
1,170
Annual IC Time Burden (Hours)
294
0
0
0
0
294
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA-3885
Form SSA-3885 (02-18).pdf
06/15/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.