Information Collection

BSO Special Wage Payments Submission - Electronic Version

IC 195194 under ICR 201609-0960-012 · OMB 0960-0565.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0565 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Special Wage Reporting Screens.pdf	Other-Internet Screens

IC Title:

BSO Special Wage Payments Submission - Electronic Version

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 404.428 - 404.429

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-Internet Screens			Special Wage Reporting Screens.pdf	www.socialsecurity.gov/employer	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 26

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Farms, Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	26	26
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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