View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 3220-0195	ICR Reference No: 202411-3220-001
Status: Active	Previous ICR Reference No: 202011-3220-008
Agency/Subagency: RRB	Agency Tracking No:
Title: Statement Regarding Contributions and Support of Children
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/20/2026
	Date Received in OIRA: 01/24/2025
Terms of Clearance: The agency made minor modifications to the Supporting Statement A to explain the submission process. Prior to triannual renewal, the agency will develop a fillable PDF (inclusive of the signature field) to facilitate online completion of this form.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2029	36 Months From Approved
Responses	400	0	0
Time Burden (Hours)	400	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	400	-100	500
Annual Time Burden (Hours)	400	-100	500
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: While conducting a review of the number of responses received between 2020 – 2023 and the enhancements made in how the RRB electronically tracks and stores completed forms, it was determined the number of responds decreased to 400. The decreased more accurately reflects the current burden.

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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