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

View Information Collection (IC)

Application for Survivor Insurance Annuities
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 218 20 CFR 216 20 CFR 219 20 CFR 217

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction AA-17b (10-07) No   Paper Only
Form and Instruction AA-19a (10-07) No   Paper Only
Form AA-17cert (09-15)(all possible) Yes Yes Printable Only
Form AA-17cert (09-15) Yes Yes Printable Only
Form AA-17sum (01-19) (All possible) Yes Yes Printable Only
Form AA-17sum (01-19) (Completed) Yes Yes Printable Only
Form and Instruction AA-17b (Proposed) No   Paper Only
Form and Instruction AA-19a (Proposed) No   Paper Only

Income Security General Retirement and Disability

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

3,485 0
   
Individuals or Households
 
   86 %

  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 3,485 0 0 0 0 3,485
Annual IC Time Burden (Hours) 1,337 0 0 22 0 1,315
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
RB-3 Booklet; Furnishing Evidence to Support Your Claim 07/16/2009
RB-17 Booklet, Survivor Annuities 12/21/2018
RB-17b Booklet; Widow(ers) Disability Benefits 03/15/2019
RB-19A Booklet; Child's Disability Benefits 03/15/2019
AA-17rec; Receipt for Claim 12/21/2018
RL-1S, Transmittal Letter for Self-administered Retirement Applications 03/18/2019
AA-17, Application for Widow(ers) Annuity 12/21/2018
AA-18, Application for Mother's/Father's and Child's Annuity 12/21/2018
AA-19, Application for Child's Annuity 12/21/2018
AA-20, Application for Parent's annuity 12/21/2018
RB-9s, Events that Affect a Survivor Annuity 03/18/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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