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Federal forms, ICRs, and supporting documents

Information Collection

SSA-L3365, Request for Employee Information

IC 178761 under ICR 202411-0960-017 · OMB 0960-0508.

Documents and Forms
Document Name
Document Type
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Form
IC Document
Information Collection (IC) Details

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SSA-L3365, Request for Employee Information
 
No Modified
 
Voluntary
 
20 CFR 422.120

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-L3365 Request for Employee Information SSA-L3365 - Revised.pdf No   Paper Only

Income Security General Retirement and Disability

 

1 0
   
Individuals or Households
 
   0 %

  Requested 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 0 0 0 0 1
Annual IC Time Burden (Hours) 0 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-L3365 - Current SSA-L3365 - Current.pdf 04/01/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.