Certificate of Coverage Request via Internet - Employers (minus Denmark, Netherlands, Norway, & Sweden and Urugay)

Certificate of Coverage Request

OMB: 0960-0554

IC ID: 206901

Information Collection (IC) Details

View Information Collection (IC)

Certificate of Coverage Request via Internet - Employers (minus Denmark, Netherlands, Norway, & Sweden and Urugay)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1913

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internet Application Screen Shot Template for Most Countries.pdf http://www.ssa.gov/international/totalization_agreements.html Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

25,165 0
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   100 %

  Approved 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 25,165 0 0 -13,931 0 39,096
Annual IC Time Burden (Hours) 16,777 0 0 -9,287 0 26,064
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Certificate of Coverage Certificate of Coverage Internet Request - Australia.pdf 09/21/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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