Information Collection

Annual Earnings Monitoring

IC 157521 under ICR 199203-3220-001 · OMB 3220-0073.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0073 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	ANNUAL EARNINGS MONITORING	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	G-19(I)	No	No
Form	(II)	No	No
Form	(III)	No	No
Form	(IV)	No	No
Form	(V)	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,000	-1,663	4,663
Annual IC Time Burden (Hours)	150	-635	785
Annual IC Cost Burden (Dollars)	0	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.