Information Collection

Notices to Beneficiaries who Have Third Parties Applying for them Via ISBA

IC 184984 under ICR 200805-0960-018 · OMB 0960-0618.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0618 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NEW Notices to Beneficiaries for 3rd-Party ISBA Completion (IC 12).pdf	Other-Notices to Beneficiaries with

IC Title:

Notices to Beneficiaries who Have Third Parties Applying for them Via ISBA

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.315-.322 20 CFR 404.601-.603 20 CFR 404.1501-.1512 20 CFR 404.310-.311 20 CFR 404.330-.333

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Notices to Beneficiaries with 3rd-party IBSA completion			NEW Notices to Beneficiaries for 3rd-Party ISBA Completion (IC 12).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 28,118

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	28,118	28,118
Annual IC Time Burden (Hours)	2,343	2,343
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.