Information Collection

Statement Regarding the Inferred Death of an Individual by Reason of Continued and Unexplained Absence

IC 8863 under ICR 201101-0960-006 · OMB 0960-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-723 Statement Regarding the Inferred Death of an Individual by Reason of Continued and Unexplained Absence	Form
SSA-723 Statement Regarding the Inferred Death of an Individual ssa-723 (revised).pdf	Form
ssa-723.pdf SSA-723 (current)	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 404.720-.721

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-723	Statement Regarding the Inferred Death of an Individual by Reason of Continued and Unexpected Absence	ssa-723 (revised).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: 3,000

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	3,000	3,000
Annual IC Time Burden (Hours)	1,500	1,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-723 (current)	ssa-723.pdf	01/18/2011

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