Nonsubstantive Change for Form G-19L

United States of America

RAILROAD RETIREMENT BOARD
844 NORTH RUSH STREET
CHICAGO, ILLINOIS 60611-1275

BUREAU OF INFORMATION SERVICES

March 22, 2022

Jamie Dickerson
Office of Information and Regulatory Affairs – OMB Desk Officer
Washington, DC 20503
Dear Mrs. Dickerson,
The Railroad Retirement Board (RRB) requests to make non-substantive and minor cosmetic
changes to a currently approved collection (3220-0179), Annual Earnings Questionnaire for
Annuitants in Last Pre-Retirement Non-Railroad Employment.
We would like to modify Form G-19L, Annual Earnings Questionnaire, to revise the first paragraph
for grammar; add annuitant instructions; revise last paragraph to add PEMS phone number and
annuitant instructions; and replace Director of RSBD with Director of PEMS. This change is based
on Board Order 21-31.
The RRB is aware that this clearance expires on January 31, 2025, and we plan to follow PRA
guidelines to obtain approval; however, we are unable to delay this change as it is vital to the RRB’s
mission of administering comprehensive retirement-survivor and unemployment-sickness benefit to
the nation’s railroad workers and their families. In the spirt of transparency, we want to inform you
of this change so that when we do submit the clearance to you for approval, this change is
documented into ROCIS to avoid any confusion when the clearance comes up for renewal.
Hopefully, OMB approves the request so that we can ensure railroad applicant receive benefits in a
timely manner.
Please contact me at 312-751-4826 if you have any questions.
Sincerely,
signed by BRIAN FOSTER
BRIAN FOSTER Digitally
Date: 2022.03.22 12:03:10 -05'00'

Brian D. Foster
Clearance Officer