Information Collection

Electronic Records Express Third-Party Registration and Request Screens

IC 181427 under ICR 201203-0960-001 · OMB 0960-0767.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0767 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Change Request 0960 0767.doc www.socialsecurity.gov (exact link developed right before goes live)	Other-screen shots
PRA Screen Shot.pdf Paperwork Reduction Act	IC Document
0960-0767_screen_shots[1].doc Screen Shots ERE - Oldler Version	IC Document

IC Title:

Electronic Records Express Third-Party Registration and Request Screens

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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-screen shots			Change Request 0960 0767.doc	http://www.socialsecurity.gov (exact link developed right before goes live)	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 66,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,640,000	2,640,000
Annual IC Time Burden (Hours)	44,000	44,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Paperwork Reduction Act	PRA Screen Shot.pdf	07/22/2009
Screen Shots ERE - Oldler Version	0960-0767_screen_shots[1].doc	03/12/2012

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