Information Collection

Application For Survivor Insurance Annuities

IC 157329 under ICR 199212-3220-002 · OMB 3220-0030.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

APPLICATION FOR SURVIVOR INSURANCE ANNUITIES

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:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	AA-17	No	No
Form	AA-17B	No	No
Form	AA-18	No	No
Form	AA-19	No	No
Form	AA-19A	No	No
Form	AA-19S	No	No
Form	AA-20	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,060

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10,060	10,060
Annual IC Time Burden (Hours)	4,553	4,553
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.