OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Request for Social Security Earnings Information

IC 9428 under ICR 202012-0960-001 · OMB 0960-0525.

Documents and Forms
Document Name
Document Type
Form
Form
Other-Revised PA & PRA Statements
Other-Revised PA & PRA Statements
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Request for Social Security Earnings Information
 
No Modified
 
Voluntary
 
20 CFR 401.100 20 CFR 404.810

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-7050 Request fo Social Security Earning Information SSA-7050 - Revised.pdf Yes No Fillable Printable
Other-Revised PA & PRA Statements Revised PA & PRA Statements.pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

66,800 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 66,800 0 0 0 0 66,800
Annual IC Time Burden (Hours) 12,247 0 0 0 0 12,247
Annual IC Cost Burden (Dollars) 7,147,600 0 0 3,334,839 0 3,812,761

Title Document Date Uploaded
SSA-7050 - Current SSA-7050 - Current.pdf 12/04/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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