Information Collection

3rd Party iClaim

IC 184982 under ICR 201008-0960-006 · OMB 0960-0618.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0618 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FY 2010 Revised iClaim Screens.pdf www.socialsecurity.gov	Other-iClaim screens -- for 3rd part
FY 2010 OMB-Approved iClaim Screen Package.pdf Currently OMB Approved iClaim Screens	IC Document

IC Title:

3rd Party iClaim

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 404.315-.322 20 CFR 404.330-.333 20 CFR 404.601-.603 20 CFR 404.310-.311 20 CFR 404.1501-.1512

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
Other-iClaim screens -- for 3rd parties			FY 2010 Revised iClaim Screens.pdf	http://www.socialsecurity.gov	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 28,118

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	28,118	28,118
Annual IC Time Burden (Hours)	7,030	7,030
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Currently OMB Approved iClaim Screens	FY 2010 OMB-Approved iClaim Screen Package.pdf	08/17/2010

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