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Federal forms, ICRs, and supporting documents

Information Collection

20 CFR 404.1503b(c) & 416.903b(c)

IC 222015 under ICR 201805-0960-002 · OMB 0960-0803.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Other-Sample Template
Other-Sample Template
Other-Sample Template
Other-Sample Notice for Section 812
Information Collection (IC) Details

View Information Collection (IC)

20 CFR 404.1503b(c) & 416.903b(c)
 
No Modified
 
Mandatory
 
20 CFR 404.1503b(c) 20 CFR 416.903b(c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction BBA 812 - Paper Fact Sheet.pdf No   Paper Only
Instruction BBA812 - Internet Fact Sheet Screen Shots.pdf www.ssa.gov Yes No Printable Only
Other-Sample Template BBA 812 - Model Repsonse - For Sections 208 or 1632 of the Act.pdf www;ssa.gov Yes No Printable Only
Other-Sample Template BBA 812 - Model Response - For Section 1128 of the Act.pdf www.ssa.gov Yes No Printable Only
Other-Sample Template BBA 812 - Model Response - For Section 1129 of the Act.pdf www.ssa.gov Yes No Printable Only
Other-Sample Notice for Section 812 Sample BBA 812 Notification Letter.pdf No   Paper Only

Income Security General Retirement and Disability

 

50 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 3,000 0 0 0 0 3,000
Annual IC Time Burden (Hours) 1,000 0 0 0 0 1,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.