Information Collection

SSA-1713/Not-For-Profit

IC 44359 under ICR 200906-0960-003 · OMB 0960-0734.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0734 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1712-CN SSA-1713/Not-For-Profit	Form and Instruction
SSA-1713 Statement of Reclamation Action SSA-1713 -0709.pdf	Form
SSA-1712 Cover Letter - Statement of Reclamation Action SSA-1712 -0709.pdf	Form and Instruction
SSA-1712-CN Cover Letter CN - Statement of Reclamation Action SSA-1712 CN -0709.pdf	Form and Instruction

IC Title:

SSA-1713/Not-For-Profit

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 31 CFR 210

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	SSA-1712	Cover Letter - Statement of Reclamation Action	SSA-1712 -0709.pdf	No	Paper Only
Form	SSA-1713	Statement of Reclamation Action	SSA-1713 -0709.pdf	No	Paper Only
Form and Instruction	SSA-1712-CN	Cover Letter CN - Statement of Reclamation Action	SSA-1712 CN -0709.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: 7

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	7	7
Annual IC Time Burden (Hours)	0	0
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.