EMPLOYMENT RELATIONSHIP QUESTIONNAIRE

ICR 199408-0960-005

OMB: 0960-0040

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
114372 Migrated
ICR Details
0960-0040 199408-0960-005
Historical Active 199106-0960-002
SSA
EMPLOYMENT RELATIONSHIP QUESTIONNAIRE
Extension without change of a currently approved collection   No
Regular
Approved without change 11/02/1994
Retrieve Notice of Action (NOA) 08/17/1994
  Inventory as of this Action Requested Previously Approved
12/31/1997 12/31/1997 08/31/1994
47,500 0 47,500
19,792 0 19,792
0 0 0

THE INFORMATION COLLECTED BY THIS FORM IS USED BY THE SOCIAL SECURITY ADMINISTRATION (SSA) TO DETERMINE THE STATUS OF CERTAIN EMPLOYEES IN VARIOUS OCCUPATIONAL FIELDS. THE AFFECTED PUBLIC IS COMPRISED OF CLAIMANTS AND THEIR EMPLOYERS WHEN THE CLAIMANT'S EMPLOYEE STATUS IS QUESTIONABLE.

None
None


No

1
IC Title Form No. Form Name
EMPLOYMENT RELATIONSHIP QUESTIONNAIRE SSA-7160

  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 47,500 47,500 0 0 0 0
Annual Time Burden (Hours) 19,792 19,792 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
08/17/1994


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