Information Collection

Responding to CPA Re-Contact

IC 181577 under ICR 201604-0960-012 · OMB 0960-0760.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0760 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CBSV User Agreement - 10-1-16 Version.doc	Other-See Attachment E of the User A
CBSV User Agreement - 10-1-14 Version.doc CBSV User Agreement - 10-1-14 Version	IC Document

IC Title:

Responding to CPA Re-Contact

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 401.100

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-See Attachment E of the User Agreement			CBSV User Agreement - 10-1-16 Version.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: 5,750

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	5,750	5,750
Annual IC Time Burden (Hours)	479	479
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CBSV User Agreement - 10-1-14 Version	CBSV User Agreement - 10-1-14 Version.doc	04/14/2016

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