Information Collection

Modified Benefit Formula Questionnaire - Foreign Pension

IC 9495 under ICR 201710-0960-006 · OMB 0960-0561.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0561 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-308 Modified Benefit Formula Questionnaire - Foreign Pension	Form
Revised PA Statement.pdf	Other-Revised PA Statement
SSA-308 Screen Shots.doc	Other-MCS/POS Screens
SSA-308 Modified Benefit Formula Questionnaire--Foreign Pension SSA-308 - Revised.pdf	Form
SSA-308 - Current.pdf SSA-308 - Current	IC Document

IC Title:

Modified Benefit Formula Questionnaire - Foreign Pension

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	SSA-308	Modified Benefit Formula Questionnaire--Foreign Pension	SSA-308 - Revised.pdf	No	Fillable Printable
Other-Revised PA Statement			Revised PA Statement.pdf	No	Fillable Printable
Other-MCS/POS Screens			SSA-308 Screen Shots.doc	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,426

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	2,426	-11,026	13,452
Annual IC Time Burden (Hours)	404	-1,838	2,242
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-308 - Current	SSA-308 - Current.pdf	11/28/2017

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