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Federal forms, ICRs, and supporting documents

Information Collection

Employee Identification Statement

IC 9364 under ICR 202006-0960-003 · OMB 0960-0473.

Documents and Forms
Document Name
Document Type
Form
Other-Revised PRA Statement
Other-Revised PRA Statement
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Employee Identification Statement
 
No Modified
 
Voluntary
 
20 CFR 404.702

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-4156 Employee Identification Statement SSA-4156 (Revised).pdf No   Paper Only
Other-Revised PRA Statement Revised PRA Statement.pdf No   Paper Only

Income Security General Retirement and Disability

 

3,600 0
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   0 %

  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 3,600 0 0 -1,150 0 4,750
Annual IC Time Burden (Hours) 3,840 0 0 3,048 0 792
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-4156 - Current SSA-4156 - Current.pdf 10/05/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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