Information Collection

SSA Supplement on Retirement, Pensions, and Related Content

IC 211604 under ICR 201405-0607-003 · OMB 0607-0980.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Items Booklet SSA Supplement on Retirement, Pensions, and Related Content	Form
SIPP-SSA(L1)2014 (Attachment B)_doc.pdf	Other-Respondent Letter
Items Booklet Items Booklet 2014 SSA Items Book (Attachment A).pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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
Form	Items Booklet	Items Booklet	2014 SSA Items Book (Attachment A).pdf		Yes	Yes	Fillable Fileable
Other-Respondent Letter			SIPP-SSA(L1)2014 (Attachment B)_doc.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 62,632

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	62,632	62,632
Annual IC Time Burden (Hours)	31,316	31,316
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.