Ssa-l9784

Annual Earnings Test Direct Mail Follow-up Program Notices

OMB: 0960-0369

IC ID: 195824

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

SSA-L9784
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.452-404.455

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-L9784 Retirement, Survivors and Disability Insurance: Earnings Estimate Form 2015 SSA 9784.pdf No   Paper Only

Income Security General Retirement and Disability

 

1,270 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 1,270 0 0 0 0 1,270
Annual IC Time Burden (Hours) 212 0 0 0 0 212
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-9784 (current) SSA 9784 (current).pdf 06/02/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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