Information Collection

Certification by Religious Group

IC 43692 under ICR 201501-0960-008 · OMB 0960-0093.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0093 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-1458 Certification by Religious Group Form
SSA-1458 Certification by Religious Group SSA-1458 (Revised).pdf Form
SSA-1458 (current).pdf SSA-1458 Current Version IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Certification by Religious Group	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.1075

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-1458	Certification by Religious Group	SSA-1458 (Revised).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-1458 Current Version	SSA-1458 (current).pdf	04/09/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.