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

Annual Earnings Test-Direct Mail Follow-up Program Notices

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.