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Ssa-l9778

IC 9243 under ICR 202009-0960-010 · OMB 0960-0369.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

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SSA-L9778
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.452-404.455

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-L9778 Retirement, Survivors and Disability Insurance: Earnings Estimate Form SSA-L9778-SM-SUP (Revised - Signature Removal).pdf No   Fillable Fileable

Income Security General Retirement and Disability

 

42,630 0
   
Individuals or Households
 
   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 42,630 0 0 0 0 42,630
Annual IC Time Burden (Hours) 21,315 0 0 14,210 0 7,105
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-9778 SSA-9778 - Current Version.pdf 12/08/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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