APPLICATION FOR BENEFITS UNDER THE ITALY - U.S. INTERNATIONAL SOCIAL SECURITY AGREEMENT

ICR 198905-0960-001

OMB: 0960-0445

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0445 198905-0960-001
Historical Active 198606-0960-003
SSA
APPLICATION FOR BENEFITS UNDER THE ITALY - U.S. INTERNATIONAL SOCIAL SECURITY AGREEMENT
Revision of a currently approved collection   No
Regular
Approved without change 05/26/1989
Retrieve Notice of Action (NOA) 05/05/1989
  Inventory as of this Action Requested Previously Approved
05/31/1992 05/31/1992 08/31/1989
180 0 240
60 0 80
0 0 0

THE INFORMATION IS USED TO DETERMINE IF A RESIDENT OF ITALY IS ELIGIBL FOR SOCIAL SECURITY BENEFITS UNDER THE ITALY - U.S. SOCIAL SECURITY AGREEMENT. THE RESPONDENTS ARE ITALIAN RESIDENTS WHO FILE FOR U.S. BENEFITS WITH THE ITALIAN SOCIAL SECURITY AGENCY.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR BENEFITS UNDER THE ITALY - U.S. INTERNATIONAL SOCIAL SECURITY AGREEMENT SSA-2528

  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 180 240 0 0 -60 0
Annual Time Burden (Hours) 60 80 0 0 -20 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.
05/05/1989


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