FEDERAL BENEFIT QUESTIONNAIRE, PRE-1957 MILITARY SERVICE

ICR 199502-0960-003

OMB: 0960-0120

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
114765 Migrated
ICR Details
0960-0120 199502-0960-003
Historical Active 199112-0960-010
SSA
FEDERAL BENEFIT QUESTIONNAIRE, PRE-1957 MILITARY SERVICE
Extension without change of a currently approved collection   No
Regular
Approved without change 04/26/1995
Retrieve Notice of Action (NOA) 02/10/1995
  Inventory as of this Action Requested Previously Approved
04/30/1998 04/30/1998 04/30/1995
1 0 0
9,333 0 9,333
0 0 0

SECTIONS 217(A) AND (E) OF THE SOCIAL SECURITY ACT PROVIDE FOR INFORMATION REGARDING THE CREDITING OF MILITARY SERVICE TO THE WAGE EARNER'S EARNINGS RECORD. THIS FORM IS USED TO SOLICIT SUFFICIENT INFORMATION TO MAKE A DETERMINATION OF ELIGIBILITY.

None
None


No

1
IC Title Form No. Form Name
FEDERAL BENEFIT QUESTIONNAIRE, PRE-1957 MILITARY SERVICE SSA-2512

  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 1 0 0 1 0 0
Annual Time Burden (Hours) 9,333 9,333 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.
02/10/1995


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