Application for Benefits Under a U.S. International Social Security Agreement (Paper)

Application for Benefits Under a U.S. International Social Security Agreement

OMB: 0960-0448

IC ID: 9326

Information Collection (IC) Details

View Information Collection (IC)

Application for Benefits Under a U.S. International Social Security Agreement (Paper)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1925

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-2490-BK Application for Benefits Under a U.S. International Social Security Agreement SSA-2490-BK (revised).pdf No   Paper Only
Other-database screens MCS Screens for the SSA-2490.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

2,025 0
   
Individuals or Households
 
   0 %

  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 2,025 0 0 0 0 2,025
Annual IC Time Burden (Hours) 1,013 0 0 0 0 1,013
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-2490-BK (current) SSA-2490-BK (current).pdf 05/09/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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