Information Collection Request

Partnership Questionnaire

ICR 202404-0960-012 · OMB 0960-0025 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-7104 Partnership Questionnaire Form Modified Available
Form SSA-7104 Partnership Questionnaire (mailed) Form Modified Repair queued
Form SSA-7104 Partnership Questionnaire Form New Available
Form SSA-7104 Partnership Questionnaire (completed in or brought to a field office) Form New Repair queued
0960-0025 Addendum.docx Supplementary Document Uploaded 2024-07-03 Repair queued
Supporting Statement - 0025 (Final).docx Supporting Statement A Uploaded 2024-07-10 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8923 Partnership Questionnaire (mailed) Other-Revised Privacy Act Statement Modified
8923 Partnership Questionnaire (mailed) Form ModifiedPartnership Questionnaire
8923 Partnership Questionnaire (mailed) Form Modified
269180 Partnership Questionnaire (completed in or brought to a field office) Other-Privacy Act Statement (revised) New
269180 Partnership Questionnaire (completed in or brought to a field office) Form NewPartnership Questionnaire
269180 Partnership Questionnaire (completed in or brought to a field office) Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2027 36 Months From Approved 08/31/2024
6,462 0 12,350
5,385 0 12,350
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Partnership Questionnaire (completed in or brought to a field office) SSA-7104
Partnership Questionnaire (mailed) SSA-7104

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 6,462 12,350 0 0 -5,888 0
Annual Time Burden (Hours) 5,385 12,350 0 0 -6,965 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No