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Form SSA-L4163 Agency/Employer Government Pension Offset Questionnaire
Agency/Employer Government Pension Offset Questionnaire
SSA-L4163 - Current
Agency/Employer Government Pension Offset Questionnaire
OMB: 0960-0470
OMB.report
SSA
OMB 0960-0470
ICR 201602-0960-012
IC 9355
Form SSA-L4163 Agency/Employer Government Pension Offset Questionnaire
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0470 can be found here:
2022-10-03 - Revision of a currently approved collection
2019-08-02 - Revision of a currently approved collection
Document [pdf]
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pdf
File Type
application/pdf
File Title
P352B82-20160210143935
File Modified
2016-05-23
File Created
2016-02-10
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