OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Personal Interview (SSA Field Office)

IC 195110 under ICR 202010-0960-002 · OMB 0960-0784.

Documents and Forms
Document Name
Document Type
Other-Intranet Screens
Other-Intranet Screens
Other-Revised Privacy Act Statement
Other-Revised Privacy Act Statement
Other-0784 Privacy Act Statement
Other-0784 Privacy Act Statement
Information Collection (IC) Details

View Information Collection (IC)

Personal Interview (SSA Field Office)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 418.2255 20 CFR 418.1265 20 CFR 418.2265 20 CFR 418.1255 20 CFR 418.2205 20 CFR 418.1205

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Intranet Screens IRMAA Screens.pdf Yes Yes Fillable Fileable Signable
Other-Revised Privacy Act Statement 0784 PRA (revised).pdf Yes Yes Printable Only
Other-0784 Privacy Act Statement 0784 Privacy Act Statement (revised).pdf Yes Yes Printable Only

Income Security General Retirement and Disability

 

178,840 0
   
Individuals or Households
 
   100 %

  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 178,840 0 0 38,462 0 140,378
Annual IC Time Burden (Hours) 250,376 0 0 180,187 0 70,189
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.
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