Information Collection Request

Repayment of Debt

ICR 201304-3220-001 · OMB 3220-0169 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form G-421F (04-10) Repayment by Credit Card Form Modified Repair queued
Form G-421F (04-10) Repayment by Credit Card Form Modified Repair queued
Form DR-422C (07-08).pdf Supplementary Document Uploaded 2013-04-26 Available
3220-0169.doc Supporting Statement A Uploaded 2013-04-26 Available
DR-422d (04-05).pdf Supplementary Document Uploaded 2006-09-29 Available
Form DR-422A (07-08).pdf Supplementary Document Uploaded 2013-04-26 Available
Form G-421 (04-08).pdf Supplementary Document Uploaded 2013-04-26 Available
G-66B (02-03).pdf Supplementary Document Uploaded 2006-09-29 Repair queued
G-66 (02-03).pdf Supplementary Document Uploaded 2006-09-29 Repair queued
Form G-66A (05-08).pdf Supplementary Document Uploaded 2013-04-26 Available
IC Document Collections
IC IDCollectionTypeStatusForm
45464 Repayment by Credit Card Form Modified
33968 Repayment by Credit Card Form Modified
ICR Details
3220-0169 201304-3220-001
Historical Active 200912-3220-001
RRB
Repayment of Debt
Revision of a currently approved collection   No
Regular
Approved without change 08/21/2013
Retrieve Notice of Action (NOA) 04/26/2013
  Inventory as of this Action Requested Previously Approved
08/31/2016 36 Months From Approved 08/31/2013
535 0 300
45 0 25
0 0 0

When the RRB determines that an overpayment of benefits under the Railroad Retirement Act or Railroad Unemployment Insurance Act has occurred, it initiates prompt action to notify the claimant of the overpayment and to recover the amount owed. The collection obtains information needed to allow for repayment by the claimant by credit card, in addition to the customary form of payment by check or money order.

US Code: 45 USC 231(i) Name of Law: Railroad Retirement Act
   US Code: 45 USC 362(l) Name of Law: Railroad Unemployment Insurance Act
  
None

Not associated with rulemaking

  78 FR 6152 01/29/2013
78 FR 23559 04/19/2013
No

2
IC Title Form No. Form Name
Repayment by Credit Card G-421F (proposed), G-421F (04-10) Repayment by Credit Card ,   Repayment By Credit Card
Repayment by Credit Card G-421F(proposed), G-421F (04-10) Repayment by Credit Card ,   Repayment by Credit Card

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 535 300 0 0 235 0
Annual Time Burden (Hours) 45 25 0 0 20 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The adjustment of +235 responses and +20 burden hours are due largely to improved internal tracking methods.

$0
No
Yes
No
No
No
Uncollected
Charles Mierzwa 312-751-3363 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/26/2013