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Federal forms, ICRs, and supporting documents

Information Collection

Cost Reimbursable Research Request--Application Reporting

IC 179744 under ICR 201304-0960-003 · OMB 0960-0754.

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Form and Instruction
Form
Form
IC Document
IC Document
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Cost Reimbursable Research Request--Application Reporting
 
No Modified
 
Voluntary
 
20 CFR Pt. 401.165  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-9901 HOW TO REQUEST SSA PROGRAM DATA FOR RESEARCH SSA-9901 revised.pdf Yes Yes Fillable Fileable
Form SSA-9902 Confidentiality Agreement SSA-9902 revised.pdf Yes Yes Fillable Fileable
Form SSA-9903 SSA Agreement Regarding Conditions For Use of SSA Data SSA-9903.pdf Yes Yes Fillable Fileable
Instruction UsersManual.pdf Yes Yes Printable Only

Income Security General Retirement and Disability

 

15 0
   
Federal Government
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 15 0 0 0 0 15
Annual IC Time Burden (Hours) 60 0 0 0 0 60
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-9901(current) SSA-9901.doc 06/23/2010
SSA-9902(current) SSA-9902.doc 06/23/2010
SSA-9903 SSA-9903.doc 06/23/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.