Information Collection

Automated Telephone Requestors SSA-1099/1042S

IC 204526 under ICR 202502-0960-009 · OMB 0960-0583.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSA_N8NN.pdf	Other-Automated Telephone Requestor
SSA_N8NN.pdf	Other-Automated Telephone Requestor
Privacy Act Statement.doc	Other-Privacy Act Statement 0583
Privacy Act Statement.doc	Other-Privacy Act Statement 0583

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: 20 CFR 401.45

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
Other-Automated Telephone Requestor Screens					Yes	Yes	Paper Only
Other-Privacy Act Statement 0583					Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 316,000

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	316,000	77,714	238,286
Annual IC Time Burden (Hours)	142,200	58,800	83,400
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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