eCBSV Applicants – SSA-157 with Certification Statement

Data Exchange Request Form

OMB: 0960-0802

IC ID: 235841

Information Collection (IC) Details

View Information Collection (IC)

eCBSV Applicants – SSA-157 with Certification Statement
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-157 Data Exchange Request Form SSA-157 - Current.pdf Yes Yes Fillable Fileable Signable
Instruction eCBSV Instructional Example SSA-157.pdf Yes Yes Fillable Fileable Signable
Other-eCBSV Initial Rollout MOU eCBSV 50 Percent RA MOU - FINAL.pdf No   Paper Only

Income Security General Retirement and Disability

 

200 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 0 0 -200 0 0 200
Annual IC Time Burden (Hours) 0 0 -107 0 0 107
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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