Information Collection

Modified Benefit Formula Questionnaire - Greenberg Cases

IC 213556 under ICR 202103-0960-005 · OMB 0960-0561.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0561 can be found here:

Documents and Forms

Document Name Document Type
Settlement Claim Review Request Form.docx Other-Telephone interview

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Modified Benefit Formula Questionnaire - Greenberg Cases	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Telephone interview			Settlement Claim Review Request Form.docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 283	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-283	283
Annual IC Time Burden (Hours)	-283	283
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.