Information Collection

Annual Earnings Test-Direct Mail Follow-up Program Notices; 20 CFR 404.452-.455

IC 9243 under ICR 200609-0960-014 · OMB 0960-0369.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0369 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-L9778 Annual Earnings Test-Direct Mail Follow-up Program Notices; 20 CFR 404.452-.455	Form and Instruction
SSA-L9778 Retirement, Survivors and Disability Insurance: Earnings SSA-L9778.pdf	Form and Instruction
SSA-L9779 Retirement, Survivors and Disability Insurance: Earnings SSA-L9779.pdf	Form and Instruction
SSA-L9781 Retirement, Survivors and Disability Insurance: Earnings SSA-L9781.pdf	Form and Instruction
SSA-L9784 Retirement, Survivors and Disability Insurance: Earnings SSA-L9784.pdf	Form and Instruction
SSA-L9785 Retirement, Survivors and Disability Insurance: Earnings SSA-L9785.pdf	Form and Instruction

IC Title:

Annual Earnings Test-Direct Mail Follow-up Program Notices; 20 CFR 404.452-.455

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.452-404.455

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	SSA-L9778	Retirement, Survivors and Disability Insurance: Earnings Estimate Form	SSA-L9778.pdf	No	Paper Only
Form and Instruction	SSA-L9784	Retirement, Survivors and Disability Insurance: Earnings Estimate Form	SSA-L9784.pdf	No	Paper Only
Form and Instruction	SSA-L9785	Retirement, Survivors and Disability Insurance: Earnings Estimate Form	SSA-L9785.pdf	No	Paper Only
Form and Instruction	SSA-L9781	Retirement, Survivors and Disability Insurance: Earnings Estimate Form	SSA-L9781.pdf	No	Paper Only
Form and Instruction	SSA-L9779	Retirement, Survivors and Disability Insurance: Earnings Estimate Form	SSA-L9779.pdf	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 225,000

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	225,000	225,000
Annual IC Time Burden (Hours)	37,500	37,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.