Information Collection

Statement Of Agricultural Employer

IC 114345 under ICR 199112-0960-005 · OMB 0960-0036.

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Document Name	Document Type

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IC Title:

STATEMENT OF AGRICULTURAL EMPLOYER

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-1002				No	No
Form	SSA-1003				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 125,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Farms

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	125,000	125,000
Annual IC Time Burden (Hours)	32,500	32,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.