Information Collection

Ssa-l8551-u3

IC 183770 under ICR 201201-0960-002 · OMB 0960-0189.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0189 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSA-8551-U3 Revised final.docx	Other-Notice
SSA-L8551-U3 Current Version.pdf Revised SSA-L8551-U3 - Used only for Transaction Accuracy Review FY2011	IC Document

IC Title:

SSA-L8551-U3

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

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-Notice			SSA-8551-U3 Revised final.docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 95

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	95	95
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Revised SSA-L8551-U3 - Used only for Transaction Accuracy Review FY2011	SSA-L8551-U3 Current Version.pdf	10/26/2011

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