Information Collection

Form 8955-SSA, Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits

IC 194025 under ICR 202206-1545-007 · OMB 1545-2187.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2187 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8955-SSA Form 8955-SSA, Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits	Form
i8955-ssa--2021-00-00.pdf	Instruction
i8955-ssa--2021-00-00.pdf	Instruction
8955-SSA Annual Registration Statement Identifying Separated Part f8955-ssa--2021-00-00.pdf	Form
8955-SSA Annual Registration Statement Identifying Separated Part f8955-ssa--2021-00-00.pdf	Form

IC Title:

Form 8955-SSA, Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 26 CFR 1.6057

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
Form	8955-SSA	Annual Registration Statement Identifying Separated Participants With Deferred Vested Benefits	f8955-ssa--2021-00-00.pdf		Yes	Yes	Fillable Fileable
Instruction			i8955-ssa--2021-00-00.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title: IRS 34.037 Audit Trail and Security Records System IRS 24.046 Customer Account Data Engine Business Master File

FR Citation: 83 FR 42980

Number of Respondents: 200,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	200,000	200,000
Annual IC Time Burden (Hours)	166,000	166,000
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.