Information Collection

BSO Special Wage Payments Submission - Electronic Version

IC 195194 under ICR 201912-0960-004 · OMB 0960-0565.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0565 can be found here:

Documents and Forms

Document Name Document Type
Special Wage Reporting Screens.pdf www.socialsecurity.gov/employer Other-Internet Screens
Special Wage Reporting Screens.pdf www.socialsecurity.gov/employer Other-Internet Screens

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	BSO Special Wage Payments Submission - Electronic Version	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 404.428 - 404.429

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens			Special Wage Reporting Screens.pdf	www.socialsecurity.gov/employer	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 26	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Farms, Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	26	26
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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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