Information Collection

You Can Make Your Payment by Credit Card--SSA-4589

IC 187022 under ICR 200808-0960-010 · OMB 0960-0462.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0462 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-4589 You Can Make Your Payment by Credit Card--SSA-4589	Form
SSA-4589 Screen Shot.pdf	Other-Internal Use Screens
SSA-4589 You Can Make Your Payment by Credit Card SSA-4589-OP1.pdf	Form
SSA-4589 Screen Shot.pdf Electronic Screens for the SSA-4589 (internal use only)	IC Document

IC Title:

You Can Make Your Payment by Credit Card--SSA-4589

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	SSA-4589	You Can Make Your Payment by Credit Card	SSA-4589-OP1.pdf		No		Paper Only
Other-Internal Use Screens			SSA-4589 Screen Shot.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 36,500

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	36,500	36,500
Annual IC Time Burden (Hours)	3,042	3,042
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Electronic Screens for the SSA-4589 (internal use only)	SSA-4589 Screen Shot.pdf	04/03/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.