Information Collection

Application for Mother's of Father's Insurance Benefits / MCS

IC 45016 under ICR 200805-0960-004 · OMB 0960-0003.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Application for Mother's of Father's Insurance Benefits / MCS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.339-404.342 20 CFR 404.601-404.603

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: 23,750	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	23,750	23,750
Annual IC Time Burden (Hours)	5,938	5,938
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.