Information Collection

SSA-1372-FC (Foreign Claims)-Students

IC 182797 under ICR 202406-0960-005 · OMB 0960-0105.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0105 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-1372-BK-FC SSA-1372-FC (Foreign Claims)-Students	Form
0105 Privacy Act Statement (revised).docx	Other-Revised Privacy Act Statement
0105 Privacy Act Statement (revised).docx	Other-Revised Privacy Act Statement
PRA 0105.docx	Other-Revised Paperwork Reduction Ac
PRA 0105.docx	Other-Revised Paperwork Reduction Ac
SSA-1372-BK-FC Student's Statement Regarding School Attendance SSA-1372-BK-FC (revised).pdf	Form
SSA-1372-BK-FC Student's Statement Regarding School Attendance SSA-1372-BK-FC (revised).pdf	Form
SSA-1372-BK-FC (current).pdf SSA-1372-BK-FC - Current	IC Document
SSA-1372-BK-FC (current).pdf SSA-1372-BK-FC - Current	IC Document

IC Title:

SSA-1372-FC (Foreign Claims)-Students

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.350-404.352 20 CFR 404.367-404.368

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	SSA-1372-BK-FC	Student's Statement Regarding School Attendance	SSA-1372-BK-FC (revised).pdf	No	Fillable Printable
Other-Revised Privacy Act Statement			0105 Privacy Act Statement (revised).docx	No	Paper Only
Other-Revised Paperwork Reduction Act Statement			PRA 0105.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: 671

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	671	671
Annual IC Time Burden (Hours)	168	168
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-1372-BK-FC - Current	SSA-1372-BK-FC (current).pdf	08/25/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.