Information Collection

People whose SSNs SSA will verify - Reading and Signing

IC 240657 under ICR 202103-0960-013 · OMB 0960-0817.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0817 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form eCBSV User Agreeme People whose SSNs SSA will verify - Reading and Signing	Form and Instruction
eCBSV FRN Webpage Language (02-01-2021).docx	Other-eCBSV Webpage Content
eCBSV FRN Webpage Language (02-01-2021).docx	Other-eCBSV Webpage Content
eCBSV Screen Package.docx	Other-Internet Screens
eCBSV Screen Package.docx	Other-Internet Screens
eCBSV User Agreeme eCBSV User Agreement eCBSV User Agreement - Revised.docx	Form and Instruction
eCBSV User Agreeme eCBSV User Agreement eCBSV User Agreement (6-7-21) - Clean Copy.docx	Form and Instruction
eCBSV User Agreement - Current.pdf Current User Agreement	IC Document
eCBSV User Agreement - Current.pdf Current User Agreement	IC Document
eCBSV User Agreement (6-7-21) - Track Changes.docx eCBSV Revised User Agreement - Track Changes	IC Document

IC Title:

People whose SSNs SSA will verify - Reading and Signing

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 401.100

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
Form and Instruction	eCBSV User Agreement	eCBSV User Agreement	eCBSV User Agreement (6-7-21) - Clean Copy.docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-eCBSV Webpage Content			eCBSV FRN Webpage Language (02-01-2021).docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens			eCBSV Screen Package.docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,100,000,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,100,000,000	793,000,000	307,000,000
Annual IC Time Burden (Hours)	55,000,000	39,650,000	15,350,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Current User Agreement	eCBSV User Agreement - Current.pdf	03/26/2021
eCBSV Revised User Agreement - Track Changes	eCBSV User Agreement (6-7-21) - Track Changes.docx	06/08/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.