Information Collection

Social Security Statement Evaluation Survey

IC 239765 under ICR 201810-0960-002 · OMB 0960-0526.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0526 can be found here:

Documents and Forms

Document Name Document Type
Social Security Statement Evaluation Survey.pdf Other-Social Security Statement Eval
Description of Social Security Statement Evaluation Survey.docx Description of Social Security Statement Evaluation Survey IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Social Security Statement Evaluation Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Social Security Statement Evaluation Survey			Social Security Statement Evaluation Survey.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,400	1,400
Annual IC Time Burden (Hours)	700	700
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Description of Social Security Statement Evaluation Survey	Description of Social Security Statement Evaluation Survey.docx	02/05/2020

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