View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 3220-0136	ICR Reference No: 202006-3220-003
Status: Historical Active	Previous ICR Reference No: 201703-3220-002
Agency/Subagency: RRB	Agency Tracking No:
Title: Public Service Pension Questionnaires
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/29/2021
	Date Received in OIRA: 06/23/2020
Terms of Clearance: Upon resubmission, the agency will redesign Form G-208 to clarify skip logic, language and streamline the design. The agency shall evaluate whether Section 5 of Form G-208 is still utilized and/or if it can be separated as a standalone form. Upon resubmission, the agency shall evaluate and report on whether the collection can be redesigned to allow respondents with both a federal and state pension to only fill out a single form.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2023	36 Months From Approved	04/30/2021
Responses	1,170	0	1,170
Time Burden (Hours)	294	0	294
Cost Burden (Dollars)	0	0	0

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Brian Foster 312 751-4826 brian.foster@rrb.gov

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