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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.
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1-2 |
"39" |
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3-6 |
Year being reported. (CCYY) |
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7-10 |
Four-digit employer identification number assigned by the
Railroad Retirement Board. |
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11-19 |
Employee's social security account number. |
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20-39 |
Employee's surname. Spaces in such names as O'Grady or De
LaCross are acceptable. |
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40-54 |
Employee's first name. |
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55 |
Middle initial. |
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56-64 |
First Quarter Amount - 9 positions ($$$$$$$¢¢), preceded by
zero(s) if necessary. If there are no earnings for first
quarter, leave positions 54-64 blank or zero-fill. |
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65-73 |
Second Quarter Amount - 9 positions ($$$$$$$¢¢), preceded by
zero(s) if necessary. If there are no earnings for second
quarter, leave positions 65-73 blank or zero-fill. |
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74-82 |
Third Quarter Amount - 9 positions ($$$$$$$¢¢), preceded by
zero(s) if necessary. If there are no earnings for third
quarter, leave positions 74-82 blank or zero-fill. |
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83-91 |
Fourth Quarter Amount - 9 positions ($$$$$$$¢¢), preceded by
zero(s) if necessary. If there are no earnings for fourth
quarter, leave positions 83-91 blank or zero-fill. |
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92-120 |
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.
