Information Collection

You Can Make Your Payment by Credit Card--Electronic Application

IC 187022 under ICR 201111-0960-016 · OMB 0960-0462.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0462 can be found here:

Documents and Forms

Document Name Document Type
SSA-4589_Screen_Shot[1].pdf Other-Internal Use Screens

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	You Can Make Your Payment by Credit Card--Electronic Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Use Screens			SSA-4589_Screen_Shot[1].pdf		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: 171,320	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	171,320	134,820	36,500
Annual IC Time Burden (Hours)	14,277	11,235	3,042
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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