OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Application for Benefits Under the Italy-U.S. International Social Security Agreements

IC 9322 under ICR 202205-0960-006 · OMB 0960-0445.

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

View Information Collection (IC)

Application for Benefits Under the Italy-U.S. International Social Security Agreements
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1925

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-2528-IT Application for Benefits-Italy-U.S.A Agreement on Social Security SSA-2528-IT - Revised.pdf No   Paper Only
Other-Revised PA & PRA Statements Revised PA & PRA Statements.pdf No   Paper Only

Income Security General Retirement and Disability

 

462 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 462 0 0 162 0 300
Annual IC Time Burden (Hours) 154 0 0 54 0 100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-2528-IT - Current SSA-2528-IT - Current.pdf 08/30/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.