mySSA Earnings Corrections Screen Package

Online Request for Correction of Earnings Record

Documents and Forms

Document Name Document Type
mySSA Earnings Correction Screener (revised).pdf Other-mySSA Earnings Corrections Scr
mySSA Earnings Correction Screener (revised).pdf Other-mySSA Earnings Corrections Scr
mySSA Earnings Corrections Screen Package (revised).pdf Other-mySSA Earnings Corections Priv
mySSA Earnings Corrections Screen Package (revised).pdf Other-mySSA Earnings Corections Priv
mySSA Earnings Corrections Screen Package (current).pdf mySSA Earnings Correction Screens IC Document
mySSA Earnings Corrections Screen Package (current).pdf mySSA Earnings Correction Screens IC Document

Information Collection (IC) Details

IC Title:	mySSA Earnings Corrections Screen Package	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.820 20 CFR 422.125

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-mySSA Earnings Corrections Screen Package			mySSA Earnings Correction Screener (revised).pdf		Yes	Yes	Fillable Fileable Signable
Other-mySSA Earnings Corections Privacy Notice			mySSA Earnings Corrections Screen Package (revised).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 76,047	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	76,047	76,047
Annual IC Time Burden (Hours)	19,012	19,012
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
mySSA Earnings Correction Screens	mySSA Earnings Corrections Screen Package (current).pdf	07/13/2022

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