Information Collection

Online Request for Correction of Earnings Record

IC 261098 under ICR 202602-0960-003 · OMB 0960-0029.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
mySSA Earnings Corrections Screen Package (revised).docx	Other-mySSA Earnings Correction Scre
Revised Privacy Act Statement.docx	Other-Revised PA Statement
mySSA Earnings Corrections Screen Package - Current.docx mySSA Earnings Correction Screen (current)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.820 20 CFR 422.125

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-mySSA Earnings Correction Screen					Yes	Yes	Fillable Fileable
Other-Revised PA Statement					No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14,194

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	14,194	-61,853	76,047
Annual IC Time Burden (Hours)	10,646	-8,366	19,012
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
mySSA Earnings Correction Screen (current)		05/25/2026

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

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