Information Collection

Mapping and Questionnaire Documents IA 30688 A4 (SSA)

IC 235037 under ICR 201805-1090-003 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 30688 Mapping and Questionnaire Documents IA 30688 A4 (SSA)	Form and Instruction
30688 Q_SSABSO_Web_AccountManagement_201805014_DOT Q_SSABSO_Web_AccountManagement_201805014_DOT.xlsx	Form and Instruction
30688 Q_SSADiagnostic_Web_Browse_20160718 Q_SSADiagnostic_Web_Browse_20160718.xlsx	Form and Instruction
30688 Q_SSADisability_Web_AccountManagement_20181001_DOT Q_SSADisability_Web_AccountManagement_20181001_DOT.ods	Form and Instruction
30688 Q_SSAExtraHelp_Web_AccountManagement_20180517_DOT Q_SSAExtraHelp_Web_AccountManagement_20180517_DOT.xlsx	Form and Instruction
30688 Q_SSAiAppeals_Web_AccountManagement_20180803_DOT Q_SSAiAppeals_Web_AccountManagement_20180803_DOT.xlsx	Form and Instruction
30688 Q_SSAiClaim_Web_AccountManagement_20160614_DOT Q_SSAiClaim_Web_AccountManagement_20160614_DOT.xlsx	Form and Instruction
30688 Q_SSAMain_Web_Browse_20180705_DOT Q_SSAMain_Web_Browse_20180705_DOT.xlsx	Form and Instruction
30688 Q_SSAMobileWage_Mobile_AccountManagement_20180803_DOT Q_SSAMobileWage_Mobile_AccountManagement_20180803_DOT.xlsx	Form and Instruction
30688 Q_SSA-mySSA_Web_AccountManagement_11_20_18_DOT Q_SSA-mySSA_Web_AccountManagement_11_20_18_DOT.xlsx	Form and Instruction
30688 Q_SSARetirementEstimator_Web_AccountManagement_20160614 Q_SSARetirementEstimator_Web_AccountManagement_20160614.xlsx	Form and Instruction
30688 SSA Mobile Innovation Questionnaire Update 10.16.14_DOT SSA Mobile Innovation Questionnaire Update 10.16.14_DOT (1).xlsx	Form and Instruction
1090-0008 Survey Mapping Document (SSA) IA 30688 A4.xlsx 1090-0008 Survey Mapping Document (SSA) IA 30688 A4	IC Document
SSA OMB Form 11.13.2018 IA 30688 A3.pdf SSA OMB Form 11.13.2018 IA 30688 A3	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Mapping and Questionnaire Documents IA 30688 A4 (SSA)

Agency IC Tracking Number:

30688 A4

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	30688	Q_SSABSO_Web_AccountManagement_201805014_DOT	Q_SSABSO_Web_AccountManagement_201805014_DOT.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSADiagnostic_Web_Browse_20160718	Q_SSADiagnostic_Web_Browse_20160718.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSADisability_Web_AccountManagement_20181001_DOT	Q_SSADisability_Web_AccountManagement_20181001_DOT.ods	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSAExtraHelp_Web_AccountManagement_20180517_DOT	Q_SSAExtraHelp_Web_AccountManagement_20180517_DOT.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSAiAppeals_Web_AccountManagement_20180803_DOT	Q_SSAiAppeals_Web_AccountManagement_20180803_DOT.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSAiClaim_Web_AccountManagement_20160614_DOT	Q_SSAiClaim_Web_AccountManagement_20160614_DOT.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSAMain_Web_Browse_20180705_DOT	Q_SSAMain_Web_Browse_20180705_DOT.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSAMobileWage_Mobile_AccountManagement_20180803_DOT	Q_SSAMobileWage_Mobile_AccountManagement_20180803_DOT.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSA-mySSA_Web_AccountManagement_11_20_18_DOT	Q_SSA-mySSA_Web_AccountManagement_11_20_18_DOT.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	Q_SSARetirementEstimator_Web_AccountManagement_20160614	Q_SSARetirementEstimator_Web_AccountManagement_20160614.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	30688	SSA Mobile Innovation Questionnaire Update 10.16.14_DOT (1)	SSA Mobile Innovation Questionnaire Update 10.16.14_DOT (1).xlsx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,600	3,600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1090-0008 Survey Mapping Document (SSA) IA 30688 A4	1090-0008 Survey Mapping Document (SSA) IA 30688 A4.xlsx	02/21/2019
SSA OMB Form 11.13.2018 IA 30688 A3	SSA OMB Form 11.13.2018 IA 30688 A3.pdf	02/21/2019

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