Self-Employment Questionnaire

Self-Employment and Substantial Service Questionnaire

OMB: 3220-0138

IC ID: 33934

Information Collection (IC) Details

View Information Collection (IC)

Self-Employment Questionnaire
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 216.11-16

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction AA-4 (07-01) Self-Employment and Substantial Service Questionnaire AA-4 (07-01).pdf No   Paper Only
Form and Instruction AA-4 (proposed) Self-Employment and Substantial Service Questionnaire Form AA-4 (proposed).pdf No   Paper Only

Income Security General Retirement and Disability

RRB-22, Railroad Retirement, Survivor, and Pensioner Benefit System  72 FR 24635

600 0
   
Individuals or Households
 
   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 600 0 0 0 0 600
Annual IC Time Burden (Hours) 415 0 0 0 0 415
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Application for Employee Annuity AA-1(5-04).pdf 07/27/2007
Application for Spouse/Divorced Spouse Annuity AA-3 (3-07).pdf 07/27/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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