Information Collection

Certification of Elections for Reduced Spouse's Benefits

IC 9256 under ICR 201501-0960-012 · OMB 0960-0398.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0398 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-25 Certification of Elections for Reduced Spouse's Benefits	Form
SSA-25 Revised Privacy Act.doc	Other-Revised Privacy Act Statement
SSA-25 Certificate of Elections for Reduced Spouse's Benefits SSA-25 Revised Version.pdf	Form
SSA-25 Privacy Act Statement changes.doc Form SSA-25 (current)	IC Document

IC Title:

Certification of Elections for Reduced Spouse's Benefits

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.421

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	SSA-25	Certificate of Elections for Reduced Spouse's Benefits	SSA-25 Revised Version.pdf		No		Printable Only
Other-Revised Privacy Act Statement			SSA-25 Revised Privacy Act.doc		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	30,000	30,000
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Form SSA-25 (current)	SSA-25 Privacy Act Statement changes.doc	04/23/2015

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