DOMESTIC SERVICE QUESTIONNAIRE

ICR 198908-0960-014

OMB: 0960-0047

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
166451 Migrated
ICR Details
0960-0047 198908-0960-014
Historical Active 198906-0960-005
SSA
DOMESTIC SERVICE QUESTIONNAIRE
No material or nonsubstantive change to a currently approved collection   No
Emergency 08/25/1989
Approved with change 08/25/1989
Retrieve Notice of Action (NOA) 08/25/1989
  Inventory as of this Action Requested Previously Approved
08/31/1992 08/31/1992 08/31/1992
19,000 0 20,000
9,500 0 10,000
0 0 0

THE THE INFORMATION IS NEEDED TO DETERMINE IF THE DOMESTIC SERVICES OF AN INDIVIDUAL PERFORMED IN THE HOME OF A SON OR DAUGHTER ARE COVERED EMPLOYMENT UNDER THE SOCIAL SECURITY ACT. THE RESPONDENTS ARE THE EMPLOYERS OF CLAIMANTS FOR BENEFITS WHOSE ENTITLEMENT DEPENDS UPON THE DOMESTIC SERVICES EMPLOYMENT.

None
None


No

1
IC Title Form No. Form Name
DOMESTIC SERVICE QUESTIONNAIRE SSA-7155

  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 19,000 20,000 0 -1,000 0 0
Annual Time Burden (Hours) 9,500 10,000 0 -500 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.
08/25/1989


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