Information Collection

SSA-723 - Statement Regarding the Inferred Death of an Individual by Reason of Continued and Unexplained Absence

IC 238986 under ICR 201909-0960-005 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-723 Statement Regarding the Inferred Death of an Individual by Reason of Continued and Unexplained Absence SSA-723 - Statement Regarding the Inferred Death of an Individual by Reason of Continued and Unexplained Absence	Form
PRA Statement.pdf	Other-PRA Statement
PRA Statement.pdf	Other-PRA Statement
SSA-723 Statement Regarding the Inferred Death of an Individual SSA-723.pdf	Form
SSA-723 Statement Regarding the Inferred Death of an Individual SSA-723.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.721 20 CFR 404.720

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-723				No		Fillable Printable
Other-PRA Statement					No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

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
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	1,500	1,500
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.

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