Information Collection

Ssa-8510

IC 179417 under ICR 201110-0960-005 · OMB 0960-0707.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0707 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-8510 Authorization for the Social Security Administration to Obtain Personal Information SSA-8510	Form and Instruction
SSA-8510 Authorization for the Social Security Administration to Revised SSA-8510 Authorization for the SSA to Obtain Personal Info.pdf	Form and Instruction
Current Version SSA-8510 Authorization.doc Current SSA-8510	IC Document

IC Title:

SSA-8510

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 418(b)(5) (To search for a specific CFR, visit the Code of Federal Regulations.)

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 and Instruction	SSA-8510				No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,500	-1,500	5,000
Annual IC Time Burden (Hours)	292	-125	417
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current SSA-8510		11/21/2011

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

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