Information Collection

20 CFR 416.557(c)(3) and 416-557(d)(8)

IC 183680 under ICR 201608-0960-003 · OMB 0960-0769.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0769 can be found here:

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Information Collection (IC) Details

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IC Title:	20 CFR 416.557(c)(3) and 416-557(d)(8)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 416.557(c)(3) 20 CFR 416-557(d)(8) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56,464	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	56,464	24,564	31,900
Annual IC Time Burden (Hours)	28,232	12,282	15,950
Annual IC Cost Burden (Dollars)	0	0	0

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