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The information contained in this report, which is required by law under Section
7(b)(6) of the Railroad Retirement Act, is required for computation of the
Financial Interchange with the Social Security Administration and the Centers
for Medicare & Medicaid Services, and is authorized for collection under OMB
control number 3220-0132. This report is due at the Railroad Retirement Board by
no later than the last day of February. Failure to report or the making of a
false or fraudulent report can result in criminal prosecution or civil
penalties, or both.
We estimate the electronic version of this form, transmitted by FTP, takes an
average of 5 hours per response to complete, including time for reviewing the
instructions, getting the needed data, and reviewing the completed form. We
estimate the secure e-mail version of this form takes an average of 30 minutes
to complete, including time for reviewing the instructions, getting the needed
data, and reviewing the completed form.
This exhibit shows
format for submission of gross earnings reports on magnetic media. For
information about the data to be entered, refer to
Part V, Chapter 7.
Reports submitted on magnetic media are to be accompanied by a
Form G-440
 ,
"Report Specifications Sheet". Indicate the type of report (Gross
Earnings). Specify in the "Remarks" block the format used, i.e., "Gross Earnings
Annual Report of Monthly Earnings, 20XX," "Gross Earnings Annual Report of
Quarterly Earnings, 20XX," or "Gross Earnings Annual Report of Annual Earnings,
20XX." All records are 120 characters in length, unblocked.
Two 120 position tape records must be keyed whether or not both records have
earnings. (Where one record does not contain money fields, positions 1-55 must
have data.)
|
1-2 |
"28" |
|
3-6 |
Year being reported. (CCYY) |
|
7-10 |
Four-digit employer identification number assigned by the
Railroad Retirement Board. |
|
11-19 |
Employee's social security account number. |
|
20-39 |
Employee's surname. Spaces in such names as O'Grady or De
LaCross are acceptable. |
|
40-54 |
Employee's first name. |
|
55 |
Middle initial. |
|
56-64 |
January Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s) if
necessary. If there are no earnings for January, leave positions
56-64 blank or zero-fill. |
|
65-73 |
February Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s)
if necessary. If there are no earnings for February, leave
positions 65-73 blank or zero-fill. |
|
74-82 |
March Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s) if
necessary. If there are no earnings for March, leave positions
74-82 blank or zero-fill. |
|
83-91 |
April Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s) if
necessary. If there are no earnings for April, leave positions
83-91 blank or zero-fill. |
|
92-100 |
May Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s) if
necessary. If there are no earnings for May, leave positions
92-100 blank or zero-fill. |
|
101-109 |
June Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s) if
necessary. If there are no earnings for June, leave positions
101-109blank or zero-fill. |
|
110-120 |
Leave blank or zero-fill. |
|
|
|
1-2 |
"29" |
|
3-6 |
Year being reported. (CCYY) |
|
7-10 |
Four-digit employer identification number assigned by the
Railroad Retirement Board. |
|
11-19 |
Employee's social security account number. |
|
20-39 |
Employee's surname. Spaces in such names as O'Grady or De
LaCross are acceptable. |
|
40-54 |
Employee's first name. |
|
55 |
Middle initial. |
|
56-64 |
July Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s) if
necessary. If there are no earnings for July, leave positions
56-64 blank or zero-fill. |
|
65-73 |
August Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s) if
necessary. If there are no earnings for August, leave positions
65-73 blank or zero-fill. |
|
74-82 |
September Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s)
if necessary. If there are no earnings for September, leave
positions 74-82 blank or zero-fill. |
|
83-91 |
October Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s) if
necessary. If there are no earnings for October, leave positions
83-91 blank or zero-fill. |
|
92-100 |
November Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s)
if necessary. If there are no earnings for November, leave
positions 92-100 blank or zero-fill. |
|
101-109 |
December Amount - 9 positions ($$$$$$$¢¢), preceded by zero(s)
if necessary. If there are no earnings for December, leave
positions 101-109 blank or zero-fill. |
|
110-120 |
Leave blank or zero-fill. |
Paperwork Reduction Act (PRA) Notice
Federal agencies may not conduct or sponsor, and respondents are not required to
respond to, any collection of information unless it displays a valid OMB number.
If you wish, send comments regarding the accuracy of our estimates or any other
aspect of these forms, including suggestions for reducing completion time, to
Chief of Information Services
U.S. Railroad Retirement Board
844 North Rush Street, 4th floor
Chicago, IL 60611-2092
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.
We recommend using the latest version.
