Information Collection

"Part A"

IC 45804 under ICR 200610-0960-003 · OMB 0960-0741.

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Information Collection (IC) Details

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IC Title:	"Part A"	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 418.1135(c)-(e) 20 CFR 418.1140(b)-(d) 20 CFR 418.1245 20 CFR 418.1310(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,820	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
Annual Number of Responses for this IC	9,820	9,820
Annual IC Time Burden (Hours)	4,910	4,910
Annual IC Cost Burden (Dollars)	0	0

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