Upload Documents (eSubmit) Release #1

Upload Documents (eSubmit)

Documents and Forms

Document Name Document Type
Upload Documents (eSubmit) Screen Package.pdf www.ssa.gov Other-Internet Screens
Upload Documents (eSubmit) Screen Package.pdf www.ssa.gov Other-Internet Screens

Information Collection (IC) Details

IC Title:	Upload Documents (eSubmit) Release #1	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 422.505 20 CFR 404.704 20 CFR 404.1512 20 CFR 416.200 20 CFR 416.912

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens			Upload Documents (eSubmit) Screen Package.pdf	www.ssa.gov	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: 904,569	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	904,569	904,569
Annual IC Time Burden (Hours)	467,361	467,361
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.