Information Collection

International Direct Deposit

IC 9739 under ICR 201810-0960-003 · OMB 0960-0686.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0686 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1199-(Country) International Direct Deposit	Form
Forms and Countries.pdf	Other-Form numbers and Countries
SSA-1199-(Country) Direct Deposit Sign-Up Form (Name of Country) SSA-1199 (revised).pdf	Form
SSA-1199 - Current.pdf SSA-1199 - Current	IC Document

IC Title:

International Direct Deposit

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 31 CFR 210

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	SSA-1199-(Country) Revised	Direct Deposit Sign-Up Form (Name of Country)	SSA-1199 (revised).pdf		No		Paper Only
Other-Form numbers and Countries			Forms and Countries.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,750

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	13,750	1,250	12,500
Annual IC Time Burden (Hours)	1,146	104	1,042
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-1199 - Current	SSA-1199 - Current.pdf	11/28/2018

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