Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements

Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlements

OMB: 1240-0016

IC ID: 13834

Information Collection (IC) Details

View Information Collection (IC)

Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 10.528

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CA-1032 Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlement Request for Information on Earnings, Dual Benefits, Dependents and Third Party Settlements (CA-16).docx No   Printable Only

Income Security General Retirement and Disability

DOL/GOVT-1  81 FR 47418

37,056 0
   
Individuals or Households
 
   26 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 37,056 0 0 -8,105 0 45,161
Annual IC Time Burden (Hours) 12,352 0 0 -2,702 0 15,054
Annual IC Cost Burden (Dollars) 15,030 0 0 9,864 0 5,166

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