SSA-L2765, Request for Self-Employment Information

SSA-L2765, Request for Self-Employment Information, SSA-L3365, Request for Employee Information, SSA-L4002, Request for Employer Information

OMB: 0960-0508

IC ID: 9413

Information Collection (IC) Details

View Information Collection (IC)

SSA-L2765, Request for Self-Employment Information
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 422.120

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-L2765 Request for Self-Employment Information SSA-L2765 (Revised).pdf No   Paper Only

Income Security General Retirement and Disability

 

12,321 0
   
Individuals or Households
 
   0 %

  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 12,321 0 0 0 0 12,321
Annual IC Time Burden (Hours) 2,054 0 0 0 0 2,054
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-L2765 SSA-L2765(current).pdf 01/17/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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