SICK PAY AND PLAN OR SYSTEM QUESTIONNAIRE

ICR 198208-0960-009

OMB: 0960-0027

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
114309 Migrated
ICR Details
0960-0027 198208-0960-009
Historical Active 198203-0960-011
SSA
SICK PAY AND PLAN OR SYSTEM QUESTIONNAIRE
Revision of a currently approved collection   No
Regular
Approved without change 10/12/1982
Retrieve Notice of Action (NOA) 08/19/1982
  Inventory as of this Action Requested Previously Approved
04/30/1985 04/30/1985 09/30/1982
3,000 0 3,000
1,000 0 1,000
0 0 0

SECTION 209(B) OF THE SOCIAL SECURITY ACT EXCLUDES FROM WAGES CERTAIN PAYMENTS MADE UNDER AN EMPLOYER'S PLAN OR SYSTEM. THIS QUESTIONNAIRE ELICITS INFORMATION TO DETERMINE WHETHER THE EMPLOYER HAS SUCH A PLAN. THIS INFORMATION IS NECESSARY TO DETERMINE THE AMOUNT OF SOCIAL SECURITY BENEFITS PAYABLE ON THE INDIVIDUAL'S EARNINGS RECORD.

None
None


No

1
IC Title Form No. Form Name
SICK PAY AND PLAN OR SYSTEM QUESTIONNAIRE SSA-7203, (8-82)

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,000 3,000 0 0 0 0
Annual Time Burden (Hours) 1,000 1,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/19/1982


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