Information Collection

20 CFR 416.557(c)(3)

IC 183680 under ICR 200802-0960-002 · OMB 0960-0769.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0769 can be found here:

Documents and Forms

Document Name Document Type
SSA-3320F Final Rules.pdf information can be submitted via email Other-Regulation Sections

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	20 CFR 416.557(c)(3)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Regulation Sections			SSA-3320F Final Rules.pdf	information can be submitted via email	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	50,000	50,000
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.