Information Collection

SSA-L707 -- State/Local Government

IC 181648 under ICR 201006-0960-007 · OMB 0960-0766.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0766 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-L707 Request for Proof(s) from Custodian of Records SSA-L707 -- State/Local Government	Form
SSA-L707 Request for Proof(s) from Custodian of Records SSA-L707-1 (Revised).pdf	Form
G-SSA-L707-1.pdf SSA-L707 (current)	IC Document

IC Title:

SSA-L707 -- State/Local Government

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.704 20 CFR 404.720 20 CFR 404.703 20 CFR 404.721 20 CFR 404.723 20 CFR 404.725 20 CFR 404.728

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-L707				No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 501

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	501	501
Annual IC Time Burden (Hours)	84	84
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-L707 (current)		07/22/2010

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

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