SSA-L3365, Request for Employee Information

SSA-L2765, Request for Self-Employment Information, SSA-L3365, Request for Employee Information, SSA-L4002, Request for Employer Information

OMB: 0960-0508

IC ID: 178761

Information Collection (IC) Details

View Information Collection (IC)

SSA-L3365, Request for Employee Information
 
No Modified
 
Voluntary
 
20 CFR 422.120

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-L3365 Request for Employee Information Revised SSA-L3365 (for use in 2010).pdf No   Paper Only

Income Security General Retirement and Disability

 

158,334 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 158,334 0 0 -14,766 0 173,100
Annual IC Time Burden (Hours) 26,389 0 0 -2,461 0 28,850
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-L3365 Current SSA-L3365 (2009).pdf 07/09/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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