Information Collection

Partnership Questionnaire (mailed)

IC 8923 under ICR 202404-0960-012 · OMB 0960-0025.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-7104 Partnership Questionnaire (mailed)	Form
Privacy Act Statement (revised).docx	Other-Revised Privacy Act Statement
Privacy Act Statement (revised).docx	Other-Revised Privacy Act Statement
SSA-7104 Partnership Questionnaire SSA-7104 (revised).pdf	Form
SSA-7104 Partnership Questionnaire SSA-7104 (revised).pdf	Form
SSA-7104 (current).pdf SSA-7104 (current)	IC Document
SSA-7104 (current).pdf SSA-7104 (current)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR Sub K, 404.1080-404.1082(e) (To search for a specific CFR, visit the Code of Federal Regulations.)

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	SSA-7104	Partnership Questionnaire	SSA-7104 (revised).pdf	www.ssa.gov	Yes	No	Fillable Printable
Other-Revised Privacy Act Statement			Privacy Act Statement (revised).docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,308

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	4,308	-8,042	12,350
Annual IC Time Burden (Hours)	2,154	-10,196	12,350
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.