Information Collection

20 CFR 416.635(d) - Intranet/Field office interview

IC 191380 under ICR 201508-0960-006 · OMB 0960-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0740 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0740 screenshots (revised).doc	Other-Sample in-office screen shots
sample screen shots.pdf Sample in-office screens (current)	IC Document

IC Title:

20 CFR 416.635(d) - Intranet/Field office interview

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 416.635(d)

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
Other-Sample in-office screen shots			0740 screenshots (revised).doc		Yes	No	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 286,400

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	286,400	1,400	285,000
Annual IC Time Burden (Hours)	23,867	117	23,750
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Sample in-office screens (current)	sample screen shots.pdf	11/18/2015

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