G-88p (10-14)

United States of America

Railroad Retirement Board

Employer's Supplemental

Pension Report

SECTION 1 - IDENTIFYING INFORMATION

1 Social Security Number

2 Railroad Contact Official's Name and Address

, 

3 Name

4 Date Released 5 BA Number

6 Job Title or Category

Salaried

Non-Agreement

Agreement (Union)

 Fax Number: Other

SECTION 2 – GENERAL INFORMATION FOR THE EMPLOYER

For assistance in completing this form, read Part VI, Chapter 6, of the Employer Reporting Instructions located on our website at 

www.rrb.gov, which provides information about supplemental annuities and how they are affected by railroad pensions. Also read 

the “Important Notices” on the next page. Type or print legibly in ink. If you need more space than is provided, use Section 5, 

Remarks. Based on your answer to a question, you may be told to “Go to” another item. If no “Go to” instructions are given, 

answer the next item in order. Do not skip any items unless directed to do so.

SECTION 3 – EMPLOYEE’S PENSION ENTITLEMENT

7 Was the employee covered under either a 

defined benefit pension plan or money 

purchase pension plan with your railroad?

Yes – Go to Section 4

No – Go to Section 6

SECTION 4 – EMPLOYEE’S PENSION BENEFIT INFORMATION

8 Enter the name of the pension plan.

9 How is the plan funded?

Employer contributions only – Go to Item 10

Both employer and employee contributions – Go to Item 10

Employee contributions only – Go to Section 6

10 Is the monthly pension reduced by the 

amount of the RRB supplemental annuity?

Yes it is reduced

 by all of the supplemental annuity - Go to Section 6

 by part of the supplemental annuity - Enter percentage: %

No it is not reduced

11 Has the employee filed for the pension?

Yes – Go to Item 12

No – Go to Section 6 (IMPORTANT: Retain a copy of this form. Complete 

and submit it when the employee files for the pension benefit.)

12 Indicate the type of pension payment.

Monthly pension – Go to Item 13

Lump sum elected in lieu of a monthly pension – Go to Item 14

Lump sum paid under the plan’s small benefit provision – Go to Item 15

13 Monthly Pension Information

a Enter the date the employee began,

or will begin, receiving the monthly 

pension. If the date is unknown, 

enter an estimated date.

b Is the amount of the monthly pension 

based on the employer’s contributions 

greater than $43.00?

c Enter the amount of the monthly 

pension based on the employer’s 

contributions then go to Section 6.

Month Day Year Yes – Go to Section 6

 No

_____________________

Form Approved

OMB No. 3220-0089
Page 2 G-88p (10-14)

14 Lump Sum Elected In Lieu of a Monthly Pension

a Enter the date the employee would 

have begun receiving the monthly 

pension if the lump sum had not 

been elected.

b Would the amount of the monthly 

pension based on the employer’s 

contributions have been greater than 

$43.00?

c Enter the amount of the monthly 

pension based on the employer’s 

contributions then go to Section 6.

Month Day Year Yes – Go to Section 6

 No

_____________________

15 Lump Sum Paid Under Plan’s Small Benefit Provision

a Enter the date the lump sum was 

paid. 

b Enter the total amount of the lump sum. c Enter the amount of the lump sum 

based on the employer’s 

contributions. 

Month Day Year

_______________________ _____________________

SECTION 5 – REMARKS

You may use this section to enter any additional information that you feel may be important to include. Be sure to include the item

number of any answer you wish to continue.

SECTION 6 – EMPLOYER CERTIFICATION BY SUPPLEMENTAL ANNUITY CONTACT OFFICIAL

Always complete this item. I certify that I have examined this report, that it is made in good faith and that to the best of my 

knowledge and belief all entries made herein are true and correct, and in accordance with the laws and regulations applicable

hereto. I understand that providing false or fraudulent information or failing to provide required information is a violation of federal law 

punishable by fine, imprisonment or both.

_____________________________________________________ _____________________________________________

Signature of Railroad Contact Official Title

Business Telephone Number (_____)_______________ Date 

Return this form to: US Railroad Retirement Board

844 N. Rush Street, RBD-RIS

Chicago, IL 60611-2092

Fax Number: (312) 751-7192

DO NOT WRITE IN THIS AREA -- FOR RRB USE ONLY

Date Reply Received at RRB

Received By

IMPORTANT NOTICES

PAPERWORK REDUCTION ACT NOTICE

The information requested on this form is needed to determine if a reduction is required to the supplemental annuities of your retired 

employees under Section 2(h) (2) of the Railroad Retirement Act (RRA) (45 USC 231a(h)(2)). Furnishing this information is required 

by law, (Section 7(b)(6) of the RRA (45 USC 231f(b)(6))).

We estimate this form takes an average of 8 minutes to complete, including the time for reviewing the instructions, getting the 

needed data, and reviewing the completed form. Federal agencies may not conduct or sponsor, and respondents are not required to 

respond to, a collection of information unless it displays a valid OMB number. 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 Chief of Information Resources 

Management, US Railroad Retirement Board, 844 N. Rush St, Chicago, Illinois 60611-2092.