2024-26068. Proposed Collection; Comment Request

Estimate of Annual Respondent Burden

Form No.	Annual responses	Time (minutes)	Burden (hours)
AA-1 (without assistance)	30	62	31
AA-1cert (with assistance)	5,425	30	2,712
AA-1sum (with assistance)	2,750	29	1,329
AA-1 (internet) (without assistance)	0	45	0
AA-1d (with assistance)	2,600	60	2,600
AA-1d (without assistance)	5	90	7
G-204	20	15	5
Total	10,830		6,902

2. Title and purpose of information collection: Application for Survivor Insurance Annuities; OMB 3220-0030.

Under section 2(d) of the Railroad Retirement Act (RRA) (45 U.S.C. 231a), monthly survivor annuities are payable to surviving widow(er)s, parents, unmarried children, and in certain cases, divorced spouses, mothers (fathers), remarried widow(er)s, and grandchildren of deceased railroad employees if there are no qualified survivors of the employee immediately eligible for an annuity. The requirements relating to the annuities are prescribed in 20 CFR parts 216, 217, 218, and 219.

To collect the information needed to help determine an applicant's entitlement to, and the amount of, a survivor annuity the RRB uses Forms AA-17, Application for Widow(er)'s Annuity; AA-17b, Applications for Determination of Widow(er)'s Disability; AA-18, Application for Mother's/Father's and Child's Annuity; AA-19, Application for Child's Annuity; AA-19a, Application for Determination of Child's Disability; AA-20, Application for Parent's Annuity, and electronic Forms AA-17cert, Application Summary and Certification and AA-17sum, Application Summary.

The on-line automated survivor annuity application (Forms AA-17, AA-18, AA-19, and AA-20) process obtains information about an applicant's marital history, work history, benefits from other government agencies, and Medicare entitlement for a survivor annuity. An RRB representative interviews the applicant either at a field office (preferred), an itinerant point, or by telephone. During the interview, the RRB representative enters the information obtained into an on-line information system. Upon completion of the interview, the system generates, for the applicant's review, either Form AA-17cert or AA-17sum, which provides a summary of the information that the applicant provided or verified. Form AA-17cert, Application Summary and Certification, requires a tradition pen and ink “wet” signature. Form AA-17sum, Application Summary, documents the alternate signing method called “Attestation,” which is an action taken by the RRB representative to confirm and annotate in the RRB records (1) the applicant's intent to file an application; (2) the applicant's affirmation under penalty of perjury that the information provided is correct; and (3) the applicant's agreement to sign the application by proxy. When the RRB representative is unable to contact the applicant in person or by telephone, for example, the applicant lives in another country, a manual version of the appropriate form is used. One response is requested of each respondent. Completion of the forms is required to obtain a benefit.

The RRB proposes no changes to forms AA-17cert.

The RRB proposes the following changes to Form AA-17b:

• Section 1, General Instructions, the date is being updated to 12/13/24,
• Section 6, Information About Your Daily Activities, remove the word “even” from question 33 in sentence “NOT AT ALL—I cannot do the activity even with or without assistance”,
• Section 6, Information About Your Daily Activities, add “Sleeping” to the activity list for question 33,
• Section 6, Information About Your Daily Activities, rename question 34 to be question 34a,
• Section 6, Information about Your Daily Activities, add a question 34b, “Describe and explain if your condition affects your memory, concentration, or ability to understand and follow instructions. (Include when this change began.)”,
• Section 7, Information About Your Work and Earnings, question 46, update to 12-2024 in example,
• Section 10, Certification, question 65, remove the word “criminal” from the sentence to read “I know that if I am receiving a disability annuity and fail to report work and earnings promptly, I am committing a crime punishable by Federal law that may result in prosecution and/or penalty deductions in my annuity payments”, and
• Correct grammar, spacing, and heading issues within the form for consistency

The RRB proposes the following changes to Form AA-19a:

• Section 1, General Instructions, the date is being updated to 12/13/24,
• Section 5, Information About Your Daily Activities, remove the word “even” from question 28 in sentence “NOT AT ALL—I cannot do the activity even with or without assistance”,
• Section 5, Information About The Child's Daily Activities, add “Sleeping” to the activity list for question 28.
• Section 5, Information About The Child's Daily Activities, rename question 29 to be question 29a.
• Section 5, Information about Your Daily Activities, add a question 29b, “Describe and explain if your condition affects your memory, concentration, or ability to understand and follow instructions. (Include when this change began.)”
• Section 7, Information About Your Work and Earnings, question 74, update to 12-2024 in example.
• Section 10, Certification, question 99, remove the word “criminal” from the sentence to read “I know that if I am receiving a disability annuity and fail to report work and earnings promptly, I am committing a crime punishable by Federal law that may result in prosecution and/or penalty deductions in my annuity payments”, and
• Correct grammar, spacing, and heading issues within the form for consistency.

The RRB proposes minor changes to the Form AA-17sum:

• Update the outdated office hours with a link to the RRB website and the toll-free number, and
• Remove the date that the applicant would be notified of a decision in the application process. ( print page 88828)

Estimate of Annual Respondent Burden

Form No.	Annual responses	Time (minutes) 1 /	Burden (hours)
AA-17 Application Process:
AA-17cert	900	20	300
AA-17sum	2,100	19	665
AA-17b:
(With assistance)	175	50	146
(Without assistance)	20	60	18
AA-19a:
(With assistance)	200	50	167
(Without assistance)	15	70	18
Total	3,410		1,314

3. Title and purpose of information collection: Continuing Disability Report; OMB 3220-0187.

Under Section 2 of the Railroad Retirement Act (45 U.S.C. 231a), an annuity is not payable or is reduced for any month in which the annuitant works for a railroad or earns more than prescribed dollar amounts from either non-railroad employment or self-employment. Certain types of work may indicate an annuitant's recovery from disability. The provisions relating to the reduction or non-payment of an annuity by reason of work, and an annuitant's recovery from disability for work, are prescribed in 20 CFR 220.17-220.20. The RRB conducts continuing disability reviews (CDR) to determine whether an annuitant continues to meet the disability requirements of the law. Provisions relating to when and how often the RRB conducts CDR's are prescribed in 20 CFR 220.186.

Form G-254, Continuing Disability Report, is used by the RRB to develop information for a CDR determination, including a determination prompted by a report of work, return to railroad service, allegation of medical improvement, or a routine disability review call-up.

The RRB proposes the following changes to Form G-254:

• Section 5, Information about Your Condition before Full Retirement Age, remove the word “even” from question 31a in sentence “NOT AT ALL—I cannot do the activity even with or without assistance”,
• Section 5, Information about Your Condition before Full Retirement Age, add “Sleeping” to the activity list for question 31a,
• Section 5, Information about Your Condition before Full Retirement Age, add a question 31e, “Describe and explain if your condition affects your memory, concentration, or ability to understand and follow instructions. (Include when this change began.)”, and
• Correct grammar, spacing, and heading issues within the form for consistency.

Form G-254a, Continuing Disability Update Report, is used to help identify a disability annuitant whose work activity and/or recent medical history warrants completion of Form G-254 for a more extensive review. The RRB proposes no changes to Form G-254a.

Estimate of Annual Respondent Burden

Form No.	Annual responses	Time (minutes) 1 /	Burden (hours)
G-254:
Annuitant	900	40	600
Employer verification	100	5	8
Doctor, hospital, or clinic verification	100	5	8
Vocational, Rehabilitation Counselor verification	100	5	8
Other governmental agency verification	100	5	8
School verification	100	5	8
G-254a	1,350	5	113
Total	2,750		753