Information Collection

Request For Address Information From Motor Vehicle Records (ssa-l7ll) Request For Address Information From Employment Commission Records (ssa-l712)

IC 115348 under ICR 198306-0960-003 · OMB 0960-0341.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0341 can be found here:

Documents and Forms

Document Name Document Type

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Information Collection (IC) Details

View Information Collection (IC)

IC Title:	REQUEST FOR ADDRESS INFORMATION FROM MOTOR VEHICLE RECORDS (SSA-L7LL) REQUEST FOR ADDRESS INFORMATION FROM EMPLOYMENT COMMISSION RECORDS (SSA-L712)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-L711				No	No
Form	SSA-L712				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	3,333	3,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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