Information Collection

Application For Survivor Insurance Annuities

IC 176928 under ICR 198904-3220-010 · OMB 3220-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0030 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR SURVIVOR INSURANCE ANNUITIES	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	AA-17B,	No	No
Form	AA-18,	No	No
Form	AA-17,	No	No
Form	AA-20,	No	No
Form	AA-19S,	No	No
Form	AA-19A,	No	No
Form	G-476C	No	No
Form	AA-19,	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	18,410	18,410
Annual IC Time Burden (Hours)	6,003	6,003
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.