Information Collection

Ssa-l8553-u3

IC 183772 under ICR 201005-0960-004 · OMB 0960-0189.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0189 can be found here:

Documents and Forms

Document Name Document Type
SSA-L8553-U3--Phone Appointment UD.pdf Other-Notice
Revised SSA-L8553-U3.pdf Revised SSA-L8553-U3 - Used only for Transaction Accuracy Review FY2011 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SSA-L8553-U3	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Notice			SSA-L8553-U3--Phone Appointment UD.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: 2,490	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,490	800	1,690
Annual IC Time Burden (Hours)	208	67	141
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Revised SSA-L8553-U3 - Used only for Transaction Accuracy Review FY2011	Revised SSA-L8553-U3.pdf	06/15/2010

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