Information Collection

Application for Mother's of Father's Insurance Benefits Modernized Claims System (MCS) and Preliminary Claims System (PCS)

IC 45015 under ICR 201902-0960-007 · OMB 0960-0003.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0003 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screen Shots.pdf	Other-MCS Screens
PCS Screen Package.pdf	Other-PCS Screen Package
PCS Privacy Act Statement.pdf	Other-Updated Privacy Act Statement

IC Title:

Application for Mother's of Father's Insurance Benefits Modernized Claims System (MCS) and Preliminary Claims System (PCS)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.339-404.342; 20 CFR 404.601-404.603

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-MCS Screens	Screen Shots.pdf	Yes	Yes	Fillable Fileable Signable
Other-PCS Screen Package	PCS Screen Package.pdf	Yes	No	Fillable Printable
Other-Updated Privacy Act Statement for the PCS Screens	PCS Privacy Act Statement.pdf	Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 23,335

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	Previously Approved
Annual Number of Responses for this IC	23,335	23,335
Annual IC Time Burden (Hours)	5,834	5,834
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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