OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Certificate of Coverage Request via Internet - Individuals (minus Denmark, Netherlands, Norway, & Sweden)

IC 182116 under ICR 201607-0960-003 · OMB 0960-0554.

Documents and Forms
Document Name
Document Type
Other-Internet Application
Other-Revised PA
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Certificate of Coverage Request via Internet - Individuals (minus Denmark, Netherlands, Norway, & Sweden)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1913

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Revised PA PA OMB 0960-0554 Certificate of Coverage.doc Yes Yes Printable Only
Other-Internet Application WebCOC Screenshots Portugal - United Kingdom.pdf http://www.ssa.gov/international/totalization_agreements.html Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

9,407 0
   
Individuals or Households
 
   100 %

  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 9,407 0 0 0 0 9,407
Annual IC Time Burden (Hours) 6,271 0 0 0 0 6,271
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Certificate of Coverage Certificate of Coverage Internet Request - Denmark.pdf 09/21/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.