Information Collection

Centenarian Project Development Worksheets: Face-to-Face Interview; Telephone Interview; Third Party Contact; Unable to Locate

IC 191770 under ICR 201001-0960-006 · OMB 0960-0780.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0780 can be found here:

Documents and Forms

Document Name Document Type
Face to Face Worksheet.pdf Other-Interview Worksheet
Telephone Contact Worksheet.pdf Other-Interview Worksheet
3rd Party Contact Worksheet.pdf Other-Interview Worksheet

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Centenarian Project Development Worksheets: Face-to-Face Interview; Telephone Interview; Third Party Contact; Unable to Locate	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 416.204(b) 20 CFR 422.135

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview Worksheet	Face to Face Worksheet.pdf	Yes	No	Printable Only
Other-Interview Worksheet	Telephone Contact Worksheet.pdf	Yes	No	Printable Only
Other-Interview Worksheet	3rd Party Contact Worksheet.pdf	Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	14,000	14,000
Annual IC Time Burden (Hours)	3,500	3,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.