Information Collection

CEO Letter and Form Mailed to Representative

IC 242395 under ICR 202008-0960-014 · OMB 0960-0671.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0671 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
DRAFT Hearing Level Notice to Representatives - New.pdf	Other-Cover Letter
COVID-19 Telephone Hearing Agreement Form DRAFT COVID-19 Telephone Agreement form - New.pdf	Form

IC Title:

CEO Letter and Form Mailed to Representative

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.936 20 CFR 404.938 20 CFR 416.1436 20 CFR 416.1438

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
Other-Cover Letter			DRAFT Hearing Level Notice to Representatives - New.pdf		No		Paper Only
Form	N/A	COVID-19 Telephone Hearing Agreement Form	DRAFT COVID-19 Telephone Agreement form - New.pdf		No		Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 280,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	280,000	280,000
Annual IC Time Burden (Hours)	46,667	46,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.