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Get RRB ID-3S-1 2009

36 1. Please Indicate From:/To: Date (Name of Inquirer) (Phone Number) (Facsimile Number) 4. Employee's Name / (Law Firm/Insurance Company) / 2. Please Indicate To:/From: U.S. Railroad Retirement Board Office of Programs - Operations Attn: Claims Adjustment and Settlement Section 844 North Rush Street Chicago, Illinois 60611-2092 Telephone Number: (312) 751-4820 Facsimile Number: (312) 751-7185 5. Social Security Number 6. Date of Injury RRB Use Only Lien Amount *Final Yes No Y.

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