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Federal forms, ICRs, and supporting documents

Information Collection

Statement Regarding Contributions

IC 8915 under ICR 202509-0960-003 · OMB 0960-0020.

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

View Information Collection (IC)

Statement Regarding Contributions
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.360-.404.366 20 CFR 404.736

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-783 Statement Regarding Contributions SSA-783 (revised).pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

2,352 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 2,352 0 0 0 0 2,352
Annual IC Time Burden (Hours) 2,705 0 0 0 0 2,705
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-783 SSA-783 (current).pdf 09/26/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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