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

Report to U.S. SSA by Person Receiving Benefits for a Child or Adult Unable to Handle Funds/Report to U.S. SSA

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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 F.pdf Form and Instruction

Information Collection (IC) Details

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:

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 F.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: 271,142	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	271,142	24,006	247,136
Annual IC Time Burden (Hours)	22,595	2,000	20,595
Annual IC Cost Burden (Dollars)	0	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.