Information Collection

Periodic Wage Report (monthly), Ssa-425 Periodic Wage Report (bimonthly), Ssa-426 Periodic Wage Report (quarterly), Ssa-427

IC 115710 under ICR 199309-0960-005 · OMB 0960-0523.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

PERIODIC WAGE REPORT (MONTHLY), SSA-425 PERIODIC WAGE REPORT (BIMONTHLY), SSA-426 PERIODIC WAGE REPORT (QUARTERLY), SSA-427

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	SSA-425	No	No
Form	SSA-426	No	No
Form	SSA-427	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,200

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	21,300	21,300
Annual IC Time Burden (Hours)	5,325	5,325
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.