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Federal forms, ICRs, and supporting documents

Information Collection

Certificate of Coverage Request via Letter - Employers in Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay)

IC 206902 under ICR 202309-0960-007 · OMB 0960-0554.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Other-Revised PA Statement
Other-Revised PA Statement
Information Collection (IC) Details

View Information Collection (IC)

Certificate of Coverage Request via Letter - Employers in Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay)
 
No Unchanged
 
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
Instruction Sample Agreement Booklet (Internet Version) - Netherlands.pdf http://www.socialsecurity.gov/international/Agreement_Pamphlets/netherld.html Yes No Printable Only
Other-Revised PA Statement Revised PA Statement.pdf Yes No Printable Only

Income Security General Retirement and Disability

 

168 0
   
Private Sector Farms, Not-for-profit institutions, Businesses or other for-profits
 
   0 %

  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 168 0 0 0 0 168
Annual IC Time Burden (Hours) 123 0 0 0 0 123
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.