QUESTIONNAIRES FOR TEST 5 OF THE PERSONAL EARNINGS AND BENEFIT ESTIMATE STATEMENT PROJECT

ICR 199007-0960-002

OMB: 0960-0488

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0488 199007-0960-002
Historical Active
SSA
QUESTIONNAIRES FOR TEST 5 OF THE PERSONAL EARNINGS AND BENEFIT ESTIMATE STATEMENT PROJECT
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/21/1990
Retrieve Notice of Action (NOA) 07/30/1990
  Inventory as of this Action Requested Previously Approved
09/30/1991 09/30/1991
5,200 0 0
1,300 0 0
0 0 0

THE INFORMATION COLLECTED BY THESE STUDY FORMS WILL BE USED BY THE SOCIAL SECURITY ADMINISTRATION TO PLAN FOR THE EFFECTIVE IMPLEMENTATIO OF THE MANDATORY PROVISION OF STATEMENTS PART OF SECTION 1142 OF THE SOCIAL SECURITY ACT. THE AFFECTED PUBLIC WILL CONSIST OF SELECTED NON-BENEFICIARIES WHO HAVE EARNINGS.

None
None


No

1
IC Title Form No. Form Name
QUESTIONNAIRES FOR TEST 5 OF THE PERSONAL EARNINGS AND BENEFIT ESTIMATE STATEMENT PROJECT SSA-7005, TEST 5-1, 5-2 & 5-3

  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 5,200 0 0 5,200 0 0
Annual Time Burden (Hours) 1,300 0 0 1,300 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
07/30/1990


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