Information Collection

SSA-7162-OCR-SM--Report to U.S. SSA

IC 178733 under ICR 200805-0960-022 · OMB 0960-0049.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0049 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-7162-OCR-SM SSA-7162-OCR-SM--Report to U.S. SSA	Form and Instruction
SSA-7162-OCR-SM Report to U.S. SSA SSA-7162-OCR-SM.pdf	Form and Instruction

IC Title:

SSA-7162-OCR-SM--Report to U.S. SSA

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-7162-OCR-SM	Report to U.S. SSA	SSA-7162-OCR-SM.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: 247,136

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	247,136	10,636	236,500
Annual IC Time Burden (Hours)	20,595	887	19,708
Annual IC Cost Burden (Dollars)	0	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.