Claim Documentation Form - Conscientious Objector

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3240-0028 can be found here:

Documents and Forms

Document Name Document Type
Form SSS-22 Claim Documentation Form - Conscientious Objector Form
SSS-22 Claim Documentation Form - Conscientious Objector sss form 22.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Claim Documentation Form - Conscientious Objector	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSS-22	Claim Documentation Form - Conscientious Objector	sss form 22.doc		No		Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: SSS-5 Registrant Processing Records	FR Citation: 65 FR 184

Number of Respondents: 1	Number of Respondents for Small Entity: 1

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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