Other (Program Service Center) (SSA-1099/1042S)

Internet Request for Replacement of Form SSA-1099/SSA-1042S

OMB: 0960-0583

IC ID: 204529

Documents and Forms
Document Name
Document Type
Other-Call flow screens
Other-Call flow screens
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Other (Program Service Center) (SSA-1099/1042S)
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 401.45

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Call flow screens SSA_N8NN (revised).pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

69,207 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 69,207 0 0 0 0 69,207
Annual IC Time Burden (Hours) 25,376 0 0 0 0 25,376
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA_N8NN (current) SSA_N8NN (current).pdf 02/10/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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