Information Collection

f) 20 CFR 411.575; SSA-1392 - EN Payment Status Report Request

IC 191126 under ICR 201204-0960-004 · OMB 0960-0644.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0644 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-1392 f) 20 CFR 411.575; SSA-1392 - EN Payment Status Report Request Form and Instruction
SSA-1392 Employment Network Payment Status Report Request Form SSA-1392.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	f) 20 CFR 411.575; SSA-1392 - EN Payment Status Report Request	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 411.575

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-1392	Employment Network Payment Status Report Request Form	SSA-1392.pdf		Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-100	100
Annual IC Time Burden (Hours)	-8	8
Annual IC Cost Burden (Dollars)	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.