Information Collection

International Direct Deposit

IC 9739 under ICR 202603-0960-010 · OMB 0960-0686.

Documents and Forms

Document Name Document Type
Form SSA-1199-(Country) Direct Deposit Sign-Up Form (Name of Country) International Direct Deposit Form
Copies of All SSA-1199 (Country) Forms.xlsx www.ssa.gov Other-Form numbers and Countries
SSA-1199-(Country) Direct Deposit Sign-Up Form (Name of Country) SSA-1199 (Country) with Email and PO Box.pdf www.ssa.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	International Direct Deposit	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 31 CFR 210

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-1199-(Country)	Direct Deposit Sign-Up Form (Name of Country)	SSA-1199 (Country) with Email and PO Box.pdf	www.ssa.gov	No		Paper Only
Other-Form numbers and Countries			Copies of All SSA-1199 (Country) Forms.xlsx	www.ssa.gov	No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54,720	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	54,720	-394,554	449,274
Annual IC Time Burden (Hours)	35,568	-1,872	37,440
Annual IC Cost Burden (Dollars)	0	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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