Information Collection

SSA-753 Statement Regarding Marriage (Upload Documents)

IC 278682 under ICR 202601-0960-002 · OMB 0960-0017.

Documents and Forms

Document Name Document Type
Form SSA-753 Statement Regarding Marriage SSA-753 Statement Regarding Marriage (Upload Documents) Form
SSA-753 Statement Regarding Marriage SSA-753 (Upload Documents).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SSA-753 Statement Regarding Marriage (Upload Documents)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	SSA-753	Statement Regarding Marriage	SSA-753 (Upload Documents).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 165	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	165	165
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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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