Information Collection

Supplemental Statement Regarding Farming Activities of Persons Living Outside the U.S.A.

IC 9062 under ICR 202410-0960-019 · OMB 0960-0103.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-7163A-F4 Supplemental Statement Regarding Farming Activities of Persons Living Outside the U.S.A.	Form
Form SSA-7163A-F4 Supplemental Statement Regarding Farming Activities of Person Living Outside the U.S.A. Supplemental Statement Regarding Farming Activities of Persons Living Outside the U.S.A.	Form
SSA-7163A-F4 Supplemental Statement Regarding Farming Activities of P SSA-7163A (revised).pdf	Form
SSA-7163A-F4 Supplemental Statement Regarding Farming Activities of P SSA-7163A (revised).pdf	Form
SSA-7163A (current).pdf SSA-7163A-F4 - Current	IC Document
SSA-7163A (current).pdf SSA-7163A-F4 - Current	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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-7163A-F4				Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19

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	19	19
Annual IC Time Burden (Hours)	19	19
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-7163A-F4 - Current		10/24/2024

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

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