Information Collection

2021 011 Feedback Survey Mapping Doc IA30908 SSA

IC 247067 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⚠️ Notice: This information collection may be referencing outdated material.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 011 2021 011 Feedback Survey Mapping Doc IA30908 SSA 2021 011 Feedback Survey Mapping Doc IA30908 SSA	Form and Instruction
011 2021 011 Feedback Survey Mapping Doc IA30908 SSA 2021 011 Feedback Survey Mapping Doc IA30908 SSA.xlsx	Form and Instruction
1090-0008 Generic Clearance Request Form_SSA Online Statements Feedback signed (4.27.21).pdf 1090-0008 Generic Clearance Request Form_SSA Online Statements Feedback signed (4.27.21)	IC Document
1090-0008 Feedback Survey Mapping Document SSA IA 30908.docx 1090-0008 Feedback Survey Mapping Document SSA IA 30908	IC Document

IC Title:

2021 011 Feedback Survey Mapping Doc IA30908 SSA

Agency IC Tracking Number:

011

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	011				Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

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	1,000	1,000
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1090-0008 Generic Clearance Request Form_SSA Online Statements Feedback signed (4.27.21)		04/29/2021
1090-0008 Feedback Survey Mapping Document SSA IA 30908		04/29/2021

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

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