Information Collection

Letter to Employer Requesting Information About Wages Earned by Beneficiary 20 CFR 404.703, 404.801

IC 8933 under ICR 201708-0960-006 · OMB 0960-0034.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0034 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-L725 Letter to Employer Requesting Information About Wages Earned by Beneficiary 20 CFR 404.703, 404.801	Form
Revised PA Statement.pdf	Other-Revised PA Statement
SSA-L725 Letter to Employer Requesting Information About Wages Ea SSA-L725-F3 - Revised.pdf	Form
SSA-L725-F3 - Current.pdf Current SSA-L725	IC Document

IC Title:

Letter to Employer Requesting Information About Wages Earned by Beneficiary 20 CFR 404.703, 404.801

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.801 20 CFR 404.703 20 CFR 404.820

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-L725	Letter to Employer Requesting Information About Wages Earned by Beneficary	SSA-L725-F3 - Revised.pdf		No		Paper Only
Other-Revised PA Statement			Revised PA Statement.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	150,000	150,000
Annual IC Time Burden (Hours)	100,000	100,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current SSA-L725	SSA-L725-F3 - Current.pdf	11/07/2017

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