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Federal forms, ICRs, and supporting documents

Information Collection

Financial Disclosure Statement

IC 33919 under ICR 202405-3220-002 · OMB 3220-0127.

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Financial Disclosure Statement
 
No Modified
 
Voluntary
 
20 CFR 255 20 CFR 340

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction DR-423 (04-17) Financial Disclosure Statement Form DR-423 (04-17).pdf No   Paper Only

Income Security General Retirement and Disability

RRB-22, Railroad Retirement, Survivor, and Pensioner Benefit System   79 FR 58874

1,200 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 1,200 0 0 0 0 1,200
Annual IC Time Burden (Hours) 1,700 0 0 0 0 1,700
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request DR-423 For Waiver of Overpayment Form RL-423 (09-05).pdf 06/17/2014
Request for Waiver of Overpayment Recovery SSA-632BK (08-2019).pdf 11/23/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.