Information Collection

International Direct Deposit

IC 9739 under ICR 202107-0960-005 · OMB 0960-0686.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0686 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1199-(Country) International Direct Deposit	Form
Forms and Countries.pdf	Other-Form numbers and Countries
Forms and Countries.pdf	Other-Form numbers and Countries
SSA-1199-(Country) Direct Deposit Sign-Up Form (Name of Country) SSA-1199.pdf	Form
SSA-1199-(Country) Direct Deposit Sign-Up Form (Name of Country) SSA-1199.pdf	Form
SSA-1199 Caribbean Direct Deposit Sign-Up Form (Name of Country) SSA-1199 (Revised Version for Caribbean-based Countries).pdf	Form
SSA-1199 Caribbean Direct Deposit Sign-Up Form (Name of Country) SSA-1199 (Revised Version for Caribbean-based Countries).pdf	Form

IC Title:

International Direct Deposit

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 31 CFR 210

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	SSA-1199-(Country)	Direct Deposit Sign-Up Form (Name of Country)	SSA-1199.pdf	No	Paper Only
Other-Form numbers and Countries			Forms and Countries.pdf	No	Paper Only
Form	SSA-1199 Caribbean-based Countries (revised)	Direct Deposit Sign-Up Form (Name of Country)	SSA-1199 (Revised Version for Caribbean-based Countries).pdf	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,750

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	13,750	13,750
Annual IC Time Burden (Hours)	1,146	1,146
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.