Employee Identification Statement

Documents and Forms

Document Name Document Type
Revised PRA Statement.pdf Other-Revised PRA Statement
SSA-4156 Employee Identification Statement SSA-4156 - Revised.pdf Form
SSA-4156 - Current.pdf SSA-4156 - Current IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Employee Identification Statement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.702

Information Collection Instruments:

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

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,600	-1,150	4,750
Annual IC Time Burden (Hours)	600	-192	792
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.