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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Application for Spouse Annuity Under the Railroad Retirement Act
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 218.11
20 CFR 216.50
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
AA-3
Application for Spouse/Divorced Spouse Annuity
Form AA-3 (03-07)(current).pdf
Yes
No
Paper Only
Form
AA-3 (proposed)
Application for Spouse/Divorced Spouse Annuity
Form AA-3 (proposed).pdf
No
Paper Only
Form
AA-3cert
Application Summary and Certification
Form AA-3cert (09-07).pdf
Yes
Yes
Fillable Printable
Form and Instruction
AA-3cert (all possible)
Application Summary and Certification
Form AA-3cert (09-07) all possible.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Survivor Compensation
Privacy Act System of Records
Title:
RRB-22, Railroad Retirement, Survivor and Pensioner Benefit System
FR Citation:
40 FR 36268
Number of Respondents:
11,050
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
98 %
Approved
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
11,050
0
0
2,550
0
8,500
Annual IC Time Burden (Hours)
5,642
0
0
1,345
0
4,297
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
RL-1
Form RL-1 (04-07).pdf
02/25/2010
RB-3, Furnishing Evidence To Support Your Claim
Form RB-3 (11-08).pdf
02/25/2010
RB-30, Spouse/Divorced Spouse Annuity
Form RB-30 (05-09).pdf
02/25/2010
RB-9, Employee and Spouse Annuities - Events That Must Be Reported
Form RB-09 (03-09).pdf
02/25/2010
AA-7, Spouse/Divorced Application for Medicare
AA-7 (01-03).pdf
12/04/2006
G-208, Public Service Pension Questionnaire
G-208 (09-04).pdf
12/04/2006
G-19F, Earnings Information Request
Form G-19F (10-07).pdf
02/25/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.