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Request for Earnings Benefits Estimate Statement
Request for Earnings Benefits Estimate Statement
OMB: 0960-0466
IC ID: 115612
OMB.report
SSA
OMB 0960-0466
ICR 199505-0960-006
IC 115612
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0466 can be found here:
2022-10-03 - Revision of a currently approved collection
2019-08-19 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request for Earnings Benefits Estimate Statement
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-7004
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20,000,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
20,000,000
0
0
20,000,000
0
0
Annual IC Time Burden (Hours)
1,666,667
0
0
1,166,667
0
500,000
Annual IC Cost Burden (Dollars)
0
0
0
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.