Information Collection

Application For Benefits Under The Belgium - U.s. International Social Security Agreement

IC 166811 under ICR 198608-0960-020 · OMB 0960-0355.

Documents and Forms

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR BENEFITS UNDER THE BELGIUM - U.S. INTERNATIONAL SOCIAL SECURITY AGREEMENT	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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-799				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: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	200	100	100
Annual IC Time Burden (Hours)	40	20	20
Annual IC Cost Burden (Dollars)	0	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.