Information Collection

International Direct Deposit

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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-1199-(Country)			www.ssa.gov	No		Paper Only
Other-Form numbers and Countries				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 %

table that charts list of burden
	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

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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