View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Application for Employee Annuity Under the Railroad Retirement Act
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 216 20 CFR 220

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction AA-1 Application for Employee Annuity Form AA-1 (01-18).pdf No   Paper Only
Form and Instruction AA-1d Application for Determination of Employee Disability Form AA-1D (05-17).pdf No   Paper Only
Form AA-1cert (12-17) (All Possible) Application Summary and Certification Form AA-1cert (12-17) All Possible.pdf Yes Yes Fillable Printable
Form AA-1cert (12-17) (Completed) Application Summary and Certification Form AA-1cert (12-17) Completed.pdf Yes Yes Fillable Printable
Form AA-1sum (12-17) (All Possible) Application Summary Form AA-1sum (12-17) All Possible.pdf Yes Yes Fillable Printable
Form AA-1sum (12-17) (Completed) Application Summary Form AA-1sum (12-17) Completed.pdf Yes Yes Fillable Printable
Form and Instruction AA-1d Application for Determination of Employee Disability Form AA-1D (xx-xx) - Proposed.pdf No   Paper Only
Form and Instruction AA-1 (Internet) Application for Employee Annuity Form AA-1 (Internet) (Current).pdf Yes Yes Fillable Fileable
Form AA-1cert (xx-xx) (Completed) Application Summary and Certification Form AA-1cert (Proposed) Completed.pdf Yes Yes Fillable Printable
Form AA-1cert (xx-xx) (All Possible) Application Summary and Certification Form AA-1cert (Proposed) All Possible.pdf Yes Yes Fillable Printable
Form AA-1sum (xx-xx) (All Possible) Application Summary Form AA-1sum (Proposed) All Possible.pdf Yes Yes Fillable Printable
Form AA-1sum (xx-xx) (Completed) Application Summary Form AA-1sum (Proposed) Completed.pdf Yes Yes Fillable Printable

Income Security General Retirement and Disability

RRB-22; Railroad Retirement, Survivor, and Pensioner Benefit System   79 FR 58874

10,810 0
   
Individuals or Households
 
   75 %

  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 10,810 0 -4,515 0 0 15,325
Annual IC Time Burden (Hours) 6,680 0 -3,069 0 0 9,749
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Report of Medical Condition by Employer Form G-3EMP (08-15).pdf 12/09/2020
Medical Assessment Form G-250 (08-15).pdf 12/09/2020
Request for Medical Assessment Form RL-250 (09-05).pdf 12/09/2020
Employee Non-Covered Service Person Questionnaire Form G-209 (05-17).pdf 12/09/2020
Supplemental Pension Report Form G-88P (12-17).pdf 12/09/2020
Employee Application for Medicare AA-6 (01-12).pdf 12/09/2020
Transmittal Letter Form RL-1 (08-18).pdf 12/09/2020
Receipt for Claim Form AA-1int (12-17) All Possible.pdf 12/09/2020
Receipt for Claim Form AA-1int (12-17) Completed.pdf 12/09/2020
Events the Affect Employee and Spouse Annuities RB-9 (07-19).pdf 12/10/2020
How Work Affects You Railroad Benefits G-77a (11-20).pdf 12/10/2020
Age and Service Employee Annuity RB-1 (05-18).pdf 12/10/2020
Employee Application for Medicare Form AA-6 (01-12).pdf 12/10/2020
Transmittal Letter Form RL-11B (09-05).pdf 12/10/2020
Vocational Report Form G-251 (03-17).pdf 12/10/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.