OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Authorization for SSA to Obtain Account Records From A Financial Institution And Request For Records

IC 9201 under ICR 200803-0960-006 · OMB 0960-0293.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Revised SSA-4641-U2
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Authorization for SSA to Obtain Account Records From A Financial Institution And Request For Records
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 416.203 20 CFR 416.200

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-4641-U2 Authorization for the Social Security Administration to Obtain Account Records from a Financial Institution and Request for Records SSA-4641-U2.pdf No   Paper Only
Other-Revised SSA-4641-U2 SSA-4641.doc No   Paper Only

Income Security General Retirement and Disability

 

500,000 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 500,000 0 0 0 0 500,000
Annual IC Time Burden (Hours) 50,000 0 0 0 0 50,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-4641 OMB - SSA response (3).doc SSA-4641 OMB - SSA response (3).doc 01/11/2007
OMB Questions Regarding Revisions to the SSA - Follow-Up.pdf OMB Questions Regarding Revisions to the SSA - Follow-Up.pdf 01/11/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.