Information Collection

Private Printing and Modification of Prescribed Application and Other Forms

IC 9711 under ICR 202207-0960-007 · OMB 0960-0663.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0663 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Website Pathing to Instructions 0663.pdf	Instruction
Website Pathing to Instructions 0663.pdf	Instruction

IC Title:

Private Printing and Modification of Prescribed Application and Other Forms

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 422.527

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
Instruction			Website Pathing to Instructions 0663.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	25	25
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.