Information Collection

f. Respondents who request access to an extract of their SSN record

IC 213569 under ICR 202301-0960-001 · OMB 0960-0566.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0566 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSN Printout .pdf	Other-SSN Printout
SSN Printout .pdf	Other-SSN Printout

IC Title:

f. Respondents who request access to an extract of their SSN record

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 401 and 402

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
Other-SSN Printout			SSN Printout .pdf		No		Printable Only

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: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-10	10
Annual IC Time Burden (Hours)	-1	1
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.