Information Collection

Social Security Statement

IC 250582 under ICR 202111-0960-011 · OMB 0960-0526.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0526 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FY 2022 mySocial Security OVS BEVE Questionnaire.docx	Other-Social Security OVS BVE Questi
FY 2022 mySocial Security OVS BEVE Questionnaire.docx	Other-Social Security OVS BVE Questi
FY 2022 mySocial Security OVS SSC Questionnaire.docx	Other-Social Security Statement Surv
FY 2022 mySocial Security OVS SSC Questionnaire.docx	Other-Social Security Statement Surv

IC Title:

Social Security Statement

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Other-Social Security OVS BVE Questionnaire			FY 2022 mySocial Security OVS BEVE Questionnaire.docx		No		Paper Only
Other-Social Security Statement Survey			FY 2022 mySocial Security OVS SSC Questionnaire.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: 36,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	36,000	36,000
Annual IC Time Burden (Hours)	9,000	9,000
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.