OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Credit Card Payment Form

IC 9686 under ICR 202111-0960-005 · OMB 0960-0648.

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

View Information Collection (IC)

Credit Card Payment Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-1414 Credit Card Payment Form SSA-1414 (revised).pdf Yes No Fillable Printable
Other-Revised PA and PRA Statements Revised PA & PRA Statements.pdf No   Fillable Printable

Income Security General Retirement and Disability

 

6,000 0
   
Individuals or Households
 
   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 6,000 0 0 0 0 6,000
Annual IC Time Burden (Hours) 200 0 0 0 0 200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-1414 - Current SSA-1414 (current).pdf 11/15/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.