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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.