Information Collection

Pension Verification-interview Worksheet

IC 147860 under ICR 198104-2900-017 · OMB 2900-0271.

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Information Collection (IC) Details

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IC Title:	PENSION VERIFICATION-INTERVIEW WORKSHEET	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	20-8849,	No	No
Form	8849A,	No	No
Form	8849B,	No	No
Form	8849C,	No	No
Form	& 21-8848	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,028	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	4,028	4,028
Annual IC Time Burden (Hours)	4,028	4,028
Annual IC Cost Burden (Dollars)	0	0

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Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.