Information Collection

MMA Outreach Mailer Insert (Form SSA-1023)

IC 185180 under ICR 201101-0960-003 · OMB 0960-0773.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1023 MMA Outreach Mailer Insert (Form SSA-1023)	Form
SSA-1023 MMA Outreach Mailer Insert MMA Outreach Mailer Insert (0960-NEW).pdf	Form
MMA_Outreach_Phone_Message[1].doc MMA Outreach Automated Phone Message	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 418

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-1023	MMA Outreach Mailer Insert	MMA Outreach Mailer Insert (0960-NEW).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: 75,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	75,000	75,000
Annual IC Time Burden (Hours)	1,250	1,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
MMA Outreach Automated Phone Message	MMA_Outreach_Phone_Message[1].doc	03/03/2011

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