Information Collection

Farm Arrangement Questionnaire

IC 8995 under ICR 201702-0960-007 · OMB 0960-0064.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0064 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-7157 Farm Arrangement Questionnaire	Form
Revised PA Statement.pdf	Other-Revised PA Statement
SSA-7157 Farm Arrangement Questionnaire SSA-7157-F4 - Revised.pdf	Form
SSA-7157-F4 - Current.pdf SSA-7157-F4 - Current	IC Document

IC Title:

Farm Arrangement Questionnaire

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 404.1082(c)

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
Form	SSA-7157	Farm Arrangement Questionnaire	SSA-7157-F4 - Revised.pdf		No		Fillable Printable
Other-Revised PA Statement			Revised PA Statement.pdf		No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,304

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Farms

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,304	-35,696	38,000
Annual IC Time Burden (Hours)	1,152	-17,848	19,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-7157-F4 - Current	SSA-7157-F4 - Current.pdf	04/26/2017

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