Information Collection

Statement Regarding Marriage

IC 8908 under ICR 202007-0960-001 · OMB 0960-0017.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0017 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-753 Statement Regarding Marriage	Form
Form SSA-753 Statement Regarding Marriage Statement Regarding Marriage	Form
Revised PA and PRA Statements - SSA-753.pdf	Other-Revised PA and PRA Statements
Revised PA and PRA Statements - SSA-753.pdf	Other-Revised PA and PRA Statements
SSA-753 Statement Regarding Marriage SSA-753 - Revised Version.pdf	Form
SSA-753 Statement Regarding Marriage SSA-753 - Revised Version.pdf	Form
ssa-753 Form (current).pdf Current Version of the SSA-753	IC Document
ssa-753 Form (current).pdf Current Version of the SSA-753	IC Document

IC Title:

Statement Regarding Marriage

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.726

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-753				Yes	No	Fillable Fileable Signable
Other-Revised PA and PRA Statements					Yes	No	Printable Only

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40,000

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	Previously Approved
Annual Number of Responses for this IC	40,000	40,000
Annual IC Time Burden (Hours)	6,000	6,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current Version of the SSA-753		03/01/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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