Agency Forms Submitted for OMB Review, Request for Comments

In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35), the Railroad Retirement Board (RRB) is forwarding 4 Information Collection Requests (ICR) to the Office of Information and Regulatory Affairs (OIRA), Office of Management and Budget (OMB). Our ICR describes the information we seek to collect from the public. Review and approval by OIRA ensures that we impose appropriate paperwork burdens.

The RRB invites comments on the proposed collections of information to determine (1) the practical utility of the collections; (2) the accuracy of the estimated burden of the collections; (3) ways to enhance the quality, utility, and clarity of the information that is the subject of collection; and (4) ways to minimize the burden of collections on respondents, including the use of automated collection techniques or other forms of information technology. Comments to the RRB or OIRA must contain the OMB control number of the ICR. For proper consideration of your comments, it is best if the RRB and OIRA receive them within 30 days of the publication date.

1. Title and Purpose of information collection: Certification Regarding Rights to Unemployment Benefits; OMB 3220-0079.

Under Section 4 of the Railroad Unemployment Insurance Act (RUIA) (45 U.S.C. 354), an employee who leaves work voluntarily is disqualified for unemployment benefits unless the employee left work for good cause and is not qualified for unemployment benefits under any other law. RRB Form UI-45, Claimant's Statement—Voluntary Leaving of Work, is used by the RRB to obtain the claimant's statement when the claimant, the claimant's employer, or another source indicates that the claimant has voluntarily left work.

Completion of Form UI-45 is required to obtain or retain benefits. One response is received from each respondent.

Previous Requests for Comments: The RRB has already published the initial ( printed page 58924) 60-day notice (91 FR 44882 on July 17, 2026) required by 44 U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

Title: Certification Regarding Rights to Unemployment Benefits.

OMB Control Number: 3220-0079.

Form(s) submitted: UI-45.

Type of request: Revision of a currently approved collection.

Affected public: Individuals or Households.

Abstract: In administering the disqualification for the voluntary leaving of work provision of Section 4 of the Railroad Unemployment Insurance Act, the Railroad Retirement Board investigates an unemployment claim that indicates the claimant left voluntarily. The certification obtains information needed to determine if the leaving was for good cause.

Changes proposed: The RRB proposes the following changes to Form UI-45:

• In Paperwork Reduction Act/Privacy Act Notices, changed last sentence to “If you wish, send comments regarding the accuracy of our estimate, or any other aspect of this form, including suggestions for reducing completion time, to: Railroad Retirement Board, ATTN: Bureau of Information Services/Policy & Compliance, 844 N. Rush Street., Chicago, IL 60611-1275.”
• Below Paperwork Reduction Act/Privacy Act Notices, changed to “Print all answers in ink.”
• In Section 1.C., added new sentence “Include attempts you made to address issues or grievances with the employer prior to leaving.”
• In Section 3.A., changed to “Have you applied for and/or claimed any state unemployment benefits of unemployment benefits under any law other than the Railroad Unemployment Insurance Act? If “Yes,” show the name, address, and telephone number of the office/agency where you applied. If “No,” go to section 4.”
• In Section 3.B, changed to “Have you been denied any such benefits? If “Yes,” attach a copy of the notice or decision from the unemployment office at which you applied.”

The burden estimate for the ICR is as follows:

2. Title and Purpose of information collection: Self-Employment and Substantial Service Questionnaire; OMB 3220-0138.

Section 2 of the Railroad Retirement Act (RRA) (45 U.S.C. 231a) provides for payment of annuities to qualified employees and their spouses. In order to receive an age and service annuity, Section 2(e)(3) states that an applicant must stop all railroad work and give up any rights to return to such work. However, applicants are not required to stop nonrailroad work or self-employment.

The RRB considers some work claimed as “self-employment” to actually be employment for an employer. Whether the RRB classifies a particular activity as self-employment or as work for an employer depends upon the circumstances of each case. These circumstances are prescribed in 20 CFR 216.

Under the 1988 amendments to the RRA, an applicant is no longer required to stop work for a “Last Pre-Retirement Nonrailroad Employer” (LPE). However, Section 2(f)(6) of the RRA requires that a portion of the employee's Tier II benefit and supplemental annuity be deducted for earnings from the “LPE.”

The “LPE” is defined as the last person, company, or institution with whom the employee or spouse applicant was employed concurrently with, or after, the applicant's last railroad employment and before their annuity beginning date. If a spouse never worked for a railroad, the LPE is the last person for whom he or she worked.

The RRB utilizes Form AA-4, Self-Employment and Substantial Service Questionnaire, to obtain information needed to determine if the work the applicant claims is self-employment is really self-employment or work for an LPE or railroad service. If the work is self-employment, the questionnaire identifies any month in which the applicant did not perform substantial service.

Completion is voluntary. However, failure to complete the form could result in the nonpayment of benefits. One response is requested of each respondent.

Previous Requests for Comments: The RRB has already published the initial 60-day notice (91 FR 44882 on July 17, 2026) required by 44 U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

Title: Self-Employment and Substantial Service Questionnaire.

OMB Control Number: 3220-0138.

Form(s) submitted: AA-4.

Type of request: Revision of a currently approved collection.

Affected public: Individuals or Households.

Abstract: Section 2 of the Railroad Retirement Act (RRA) provides for payment of annuities to qualified employees and their spouses. Work for a Last Pre-Retirement Nonrailroad Employer (LPE), and work in self-employment affect payment in different ways. This collection obtains information to determine whether claimed self-employment is really self-employment, and not work for a railroad or LPE.

Changes proposed: The RRB proposes the following changes to the AA-4:

• On Page 1, changed grey section at the top of the page to “DO NOT WRITE IN THIS SPACE—RRB Official Use Only”.
• On Page 1, Paperwork Reduction Act/Privacy Act Notices, (1) changed 2nd sentence to “This information is needed to determine whether your self-employment or business activity (which includes all forms of work or investment regardless of profit or passive income) will affect your railroad retirement benefits under the RRA.”, (2) added new 4th sentence “If there are self-employment, business or any other type of earnings reported to the RRB that are miscategorized or incorrectly associated to you, then please inform an RRB representative so that you are given instructions on how to correct your earnings record.”, and (3) changed last sentence to “Railroad Retirement Board, ATTN: Bureau of Information Services/Policy & Compliance, 844 N. Rush Street, Chicago, IL 60611-1275.”
• In Section 1, changed year for example date to “June 6, 2026.”
• In Section 2, removed instructions below item 4.
• In Section 2, removed instructions below item 5.
• In Section 3, changed section title to “Information About Your Self- ( printed page 58925) Employment Or Business Activity” and item 7a to “Enter the name and address of your business or business activity.”
• In Section 3, item 7b, added “Gig Work (ex. ride-share) and “Limited Liability Company (LLC)” business or business activity options.
• In Section 3, added item 7c “Enter the name of the government Agency where your business or business activity is registered/incorporated.”
• In Section 3, item 8a, added “Director/Board Member”, “Farmer” and “Landlord” to job title options.
• In Section 3, item 8c, added “phone number(s)” for persons or organizations for whom you perform service.
• In Section 3, item 12, changed to “Do you advertise your services?”
• In Section 4, inserted “did not” in first sentence between “you” and “perform”.
• In Section 5, item 23, added “Note: If you need to report your earnings for any additional year(s), then provide the information in Section 6.”
• In Section 5, item 27a, inserted “agreement” between “written” and “in accordance”.
• In Section 5, item 28, changed to “Do you risk personal financial loss in your business or business activity?”
• In Section 7, item 31, changed certification to “I certify that all the information I gave the Railroad Retirement Board (RRB) on this form is true to the best of my knowledge. I know that if I have made a false or fraudulent statement on this form or withhold information in order to receive benefits from the RRB, I am committing a crime which is punishable under Federal law by fine or imprisonment or both.”

The burden estimate for the ICR is as follows:

3. Title and purpose of information collection: Vocational Report; OMB 3220-0141.

Section 2 of the Railroad Retirement Act (RRA) (45 U.S.C. 231a) provides for payment of disability annuities to qualified employees and widow(ers). The establishment of permanent disability for work in the applicant's “regular occupation” or for work in any regular employment is prescribed in 20 CFR 220.12 and 220.13 respectively.

The RRB utilizes Form G-251, Vocational Report, to obtain an applicant's work history. This information is used by the RRB to determine the effect of a disability on an applicant's ability to work. Form G-251 is designed for use with the RRB's disability benefit application forms and is provided to all applicants for employee disability annuities and to those applicants for a widow(er)'s disability annuity who indicate that they have been employed at some time.

Completion is required to obtain or retain a benefit. One response is requested of each respondent.

Previous Requests for Comments: The RRB has already published the initial 60-day notice (91 FR 44883 on July 17, 2026) required by 44 U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

Title: Vocational Report.

OMB Control Number: 3220-0141.

Form(s) submitted: G-251.

Type of request: Revision of a currently approved collection.

Affected public: Individuals or Households.

Abstract: Section 2 of the Railroad Retirement Act provides for the payment of disability annuities to qualified employees and widow(er)s. In order to determine the effect of a disability on an annuitant's ability to work, the RRB needs the applicant's work history. The collection obtains the information needed to determine their ability to work.

Changes proposed: The RRB proposes the following changes to Form G-251:

• In Section 3, item 7, added “including any self-employment” at the end of the first sentence, added “NOTE 3: If you are listing any self-employment or work for a business that you own, then also complete form AA-4, Self-Employment and Substantial Service Questionnaire.” and added “Name of Employer” column.
• In Section 3, items 12, 16 and 20, added “the interactions you have with coworkers or the public” and “vision requirements” to the list of essential duties that may be described of the position or occupation named in Item's 7a, 7b and 7c and made other minor editorial changes to make questions simpler and clearer.
• In Section 3, items 14b, 18b and 22b, replaced “Descriptive Comments” with “Description of Physical Activity” in the 2nd sentence and added “Description of Physical Activity” column.
• In Section 3, items 14b, 18b and 22b, added “³ Constantly ( 2/3 to 3/3 )” in the Amount of Time column.
• In Section 3, items 14b(4), 18b(4) and 22b(4), replaced “Crouching/Squatting/Stooping” with “Crouching/Squatting”.
• In Section 3, items 14b(5), 18b(5) and 22b(6), added “Stooping” and renumbered subsequent physical activity action options.
• In Section 3, added “³ Constantly means occurring over two-thirds (approx. 5 hours) of an 8-hour workday; cumulative, not continuous.” for footnotes related to the Amount of Time column for items 14b, 18b and 22b.
• In Paperwork Reduction Act/Privacy Act Notices, changed last sentence to “If you wish, send comments regarding the accuracy of our estimate, or any other aspect of this form, including suggestions for reducing completion time, to: Railroad Retirement Board, ATTN: Bureau of Information Services/Policy & Compliance, 844 N. Rush Street., Chicago, IL 60611-1275.”

The burden estimate for the ICR is as follows:

4. Title and Purpose of information collection: Designation of Contact Officials; 3220-0200.

Coordination between railroad employers and the RRB is essential to properly administer the payment of benefits under the Railroad Retirement Act (RRA) and the Railroad Unemployment Insurance Act (RUIA). In order to enhance timely coordination activity, the RRB utilizes Form G-117A, Designation of Contact Officials. Form G-117A is used by railroad employers to designate employees who are to act as point of contact with the RRB on a variety of RRA and RUIA-related matters.

Form G-117a (internet), Designation of Contact Officials, is available to employers who request access to the form through the RRB's Employer Reporting System (ERS). The G-117a (internet) consists of a series of screens that allows users to view the Contact Officials currently on file for the employer. Users will be able to edit and delete existing Contact Officials, as well as add new Contact Officials. The screen to edit and add Contact Officials collects essentially the same information as the approved paper Form G-117a. The internet version provides for the required notices and certifications, contains help messages to ensure users provide valid contact information, and prevents users from deleting Contact Officials without first providing a replacement.

Completion is voluntary. One response is requested from each respondent.

Previous Requests for Comments: The RRB has already published the initial 60-day notice (91 FR 44884 on July 17, 2026) required by 44 U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

Title: Designation of Contact Officials.

OMB Control Number: 3220-0200.

Form(s) submitted: G-117A & G-117A (internet).

Type of request: Revision of a currently approved collection.

Affected public: Private Sector; Businesses or other for profits.

Abstract: The Railroad Retirement Board (RRB) requests that railroad employers designate employees to act as liaison with the RRB on a variety of Railroad Retirement Act and Railroad Unemployment Insurance Act matters.

Changes proposed: The RRB proposes the following changes to Forms G-117a (Paper) and G-117a (internet):

Form G-117a (Paper):

• Changed the layout of the form to accommodate remove the “Items/Contact Official and/or Descriptions” section in the form instructions and move each Contact Official section of the form as applicable.
• Added “(4) SUPPLEMENTAL ANNUITY” Designation of Contact Official.
• Added item “(7) SECTION 2(f) BILL PAYMENT—RUIA” Designation of Contact Official.
• Added “(9) SECTION 12(o) BILL PAYMENT—RUIA” Designation of Contact Official.
• Removed “(11) STREET ADDRESS”.
• Added “(14) VERIFICATION OF EMPLOYER GROUP HEALTH PLAN” Designation of Contact Official.
• Added “(15) CERTIFICATION”.
• Renumbered items to account added Contact Officials, as applicable.
• In Paperwork Reduction Act/Privacy Act Notices, changed last sentence to “If you wish, send comments regarding the accuracy of our estimate, or any other aspect of this form, including suggestions for reducing completion time, to: Railroad Retirement Board, ATTN: Bureau of Information Services/Policy & Compliance, 844 N. Rush Street., Chicago, IL 60611-1275.”

Form G-117a (internet):

• Updated the Manage Contact Officials screen to added new contact official types to match Form G-117 (Paper).
• Updated the New Contact Official and Edit Contact Official screens to add new contact official types in the Areas of Responsibility section to match Form G-117 (Paper).

The burden estimate for the ICR is as follows:

Additional Information or Comments: Copies of the forms and supporting documents or comments regarding the information collection should be addressed to Brian Foster, Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois 60611-1275 or emailed to Brian.Foster@rrb.gov.

Written comments and recommendations for the proposed information collection should be sent within 30 days of publication of this notice to www.reginfo.gov/​public/​do/​PRAMain. Find this particular information collection by selecting “Currently under 30-day Review—Open for Public Comments” or by using the search function.