OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Partnership Questionnaire (completed in or brought to a field office)

IC 269180 under ICR 202404-0960-012 · OMB 0960-0025.

Documents and Forms
Document Name
Document Type
Form
Other-Privacy Act Statement (revised
Other-Privacy Act Statement (revised
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Partnership Questionnaire (completed in or brought to a field office)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-7104 Partnership Questionnaire SSA-7104 (revised).pdf No   Paper Only
Other-Privacy Act Statement (revised) Privacy Act Statement (revised).docx No   Paper Only

Income Security General Retirement and Disability

 

2,154 0
   
Individuals or Households
 
   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 2,154 0 0 2,154 0 0
Annual IC Time Burden (Hours) 3,231 0 0 3,231 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-7104 (current) SSA-7104 (current).pdf 07/03/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.