Information Collection

20 CFR 404.1740(b)(6) and 416.1540(b)(6)

IC 223057 under ICR 201807-0960-001 · OMB 0960-0804.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0804 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	20 CFR 404.1740(b)(6) and 416.1540(b)(6)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 416.1540(b)(6) 20 CFR 404.1740(b)(6)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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