Information Collection

Certification by Religious Group

IC 43692 under ICR 202403-0960-009 · OMB 0960-0093.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0093 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1458 Certification by Religious Group	Form and Instruction
SSA-1458 Certification by Religious Group SSA-1458.pdf	Form and Instruction
SSA-1458 Certification by Religious Group SSA-1458.pdf	Form and Instruction

IC Title:

Certification by Religious Group

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.1075

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
Form and Instruction	SSA-1458	Certification by Religious Group	SSA-1458.pdf		No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 142

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	142	0	142
Annual IC Time Burden (Hours)	71	35	36
Annual IC Cost Burden (Dollars)	0	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.