STATE'S REPORT OF WAGES PAID

ICR 198409-0960-002

OMB: 0960-0321

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
115303 Migrated
ICR Details
0960-0321 198409-0960-002
Historical Active 198211-0960-002
SSA
STATE'S REPORT OF WAGES PAID
Revision of a currently approved collection   No
Regular
Approved without change 10/18/1984
Retrieve Notice of Action (NOA) 09/14/1984
  Inventory as of this Action Requested Previously Approved
12/31/1986 12/31/1986 12/31/1984
1,500 0 3,500
3,000 0 7,000
0 0 0

THE INFORMATION COLLECTED BY THE USE OF FORM SSA-3963 IS NEEDED AND US TO MAINTAIN AN EARNINGS RECORD FOR EACH EMPLOYEE REPORTED. THE AFFECT PUBLIC IS COMPRISED OF STATE AND LOCAL GOVERNMENTS WHO HAVE ELECTED SOCIAL SECURITY COVERAGE FOR THEIR EMPLOYEES.

None
None


No

1
IC Title Form No. Form Name
STATE'S REPORT OF WAGES PAID SSA-3963

  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 1,500 3,500 0 -2,000 0 0
Annual Time Burden (Hours) 3,000 7,000 0 -4,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
09/14/1984


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