Ssa-2935

Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook

Documents and Forms

Document Name Document Type
Form SSA-2935 SSA-2935 Form and Instruction
0960-0189 - Updated PA and PRA Statements.pdf Other-Revised Privacy Act and PRA St
SSA-2935 Authorization to the Social Security Administration to O SSA-2935 - Revised Version.pdf Form and Instruction
SSA-2935 - Current Version.pdf Current SSA-2935 IC Document

Information Collection (IC) Details

IC Title:	SSA-2935	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-2935	Authorization to the Social Security Administration to Obtain Personal Informaition	SSA-2935 - Revised Version.pdf		No		Fillable Fileable
Other-Revised Privacy Act and PRA Statements			0960-0189 - Updated PA and PRA Statements.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,350	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,350	0	2,350
Annual IC Time Burden (Hours)	7,246	6,384	862
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-2935	SSA-2935 - Current Version.pdf	06/27/2025

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