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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.