Information Collection

20 CFR 404.506(e)(3)

IC 183678 under ICR 201309-0960-008 · OMB 0960-0769.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0769 can be found here:

Documents and Forms

Document Name Document Type
SSA-3320F Final Rules.pdf information can be submitted via email Other-Regulation section

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	20 CFR 404.506(e)(3)	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-Regulation section			SSA-3320F Final Rules.pdf	information can be submitted via email	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: 20,000	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	20,000	-5,000	25,000
Annual IC Time Burden (Hours)	10,000	-2,500	12,500
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.