Information Collection Request

Repayment of Debt

ICR 201912-3220-005 · OMB 3220-0169 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form G-421F (XX-XX) Repayment by Credit Card Form Modified Available
Form G-421F (XX-XX) Repayment by Credit Card Form Modified Available
3220-0169 - OIRA Changes.docx Supporting Statement A Uploaded 2020-04-17 Available
Justification for No Material_NonSubstatative Change.pdf Justification for No Material/Nonsubstantive Change Uploaded 2017-12-28 Repair queued
Form DRL-145 (12-17).pdf Supplementary Document Uploaded 2017-12-28 Available
Form DR-422B (12-17).pdf Supplementary Document Uploaded 2017-12-28 Available
Form DR-422A (12-17).pdf Supplementary Document Uploaded 2017-12-28 Available
Form G-421 (12-17).pdf Supplementary Document Uploaded 2017-12-28 Available
Form DRL-145 (07-16).pdf Supplementary Document Uploaded 2016-08-04 Available
Form SSA-714 (07-05).pdf Supplementary Document Uploaded 2016-06-08 Available
Form G-66BA (03-13).pdf Supplementary Document Uploaded 2016-06-08 Available
Form DR-422B (09-13).pdf Supplementary Document Uploaded 2016-07-18 Available
Form DR-422C (09-13).pdf Supplementary Document Uploaded 2016-07-18 Available
Form DR-422A (09-13).pdf Supplementary Document Uploaded 2016-07-18 Available
Form G-421 (04-13).pdf Supplementary Document Uploaded 2016-06-08 Available
G-66B (02-03).pdf Supplementary Document Uploaded 2006-09-29 Available
G-66 (02-03).pdf Supplementary Document Uploaded 2006-09-29 Available
Form G-66A (03-13).pdf Supplementary Document Uploaded 2016-06-08 Available
IC Document Collections
IC IDCollectionTypeStatusForm
45464 Repayment by Credit Card Form Modified
33968 Repayment by Credit Card Form Modified
ICR Details
3220-0169 201912-3220-005
Active 201712-3220-001
RRB
Repayment of Debt
Revision of a currently approved collection   No
Regular
Approved with change 04/27/2020
Retrieve Notice of Action (NOA) 12/30/2019
  Inventory as of this Action Requested Previously Approved
04/30/2023 36 Months From Approved 04/30/2020
535 0 535
45 0 45
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

  84 FR 48382 09/13/2019
84 FR 64938 11/25/2019
No

2
IC Title Form No. Form Name
Repayment by Credit Card G-421F (12-17), G-421F (XX-XX) Repayment by Debit Card - (proposed) ,   Repayment by Debit Card - (Current)
Repayment by Credit Card G-421F (12-17), G-421F (XX-XX) Repayment by Debit Card - Proposed ,   Repayment by Credit Card - Current

  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 535 535 0 0 0 0
Annual Time Burden (Hours) 45 45 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
Uncollected
Brian Foster 312 751-4826 [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.
12/30/2019