Information Collection

Internet Requestors

IC 197896 under ICR 201903-0960-004 · OMB 0960-0789.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0789 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
eAccess Privacy Act Statement (revised).docx www.ssa.gov	Other-Revised Privacy Act Statement
eAccess Screens (revised).pdf www.ssa.gov	Other-Internet Screens
eAccess Screens (current).pdf eAccess Screens (current)	IC Document

IC Title:

Internet Requestors

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 402 42 CFR 401.45

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
Other-Revised Privacy Act Statement			eAccess Privacy Act Statement (revised).docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens			eAccess Screens (revised).pdf	www.ssa.gov	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: 64,030,538

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	64,030,538	64,030,538
Annual IC Time Burden (Hours)	8,537,405	8,537,405
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
eAccess Screens (current)	eAccess Screens (current).pdf	03/22/2019

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