Information Collection

SSA Survey (Census)

IC 260379 under ICR 202305-1205-004 · OMB 1205-0542.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0542 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1205-0542 SSA Appendix A English Script.docx	Other-Survey
1205-0542 SSA Appendix A English Script - Clean 4.11.24.docx	Other-Survey
1205-0542 SSA Appendix B Spanish Script.docx	Other-Survey
1205-0542 SSA Appendix B Spanish Script.docx	Other-Survey

IC Title:

SSA Survey (Census)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 7 29 CFR 70

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-Survey			1205-0542 SSA Appendix A English Script - Clean 4.11.24.docx		Yes	Yes	Fillable Fileable
Other-Survey			1205-0542 SSA Appendix B Spanish Script.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: Job Corps Student Records (DOL/GOVT-2)

FR Citation: 67 FR 16815

Number of Respondents: 22,100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	88,400	88,400
Annual IC Time Burden (Hours)	22,100	22,100
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.