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Federal forms, ICRs, and supporting documents

Information Collection

Individuals (SSA-4641-OP1)

IC 279772 under ICR 202604-0960-001 · OMB 0960-0293.

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Document Name
Document Type
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Form
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Information Collection (IC) Details

View Information Collection (IC)

Individuals (SSA-4641-OP1)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-4641-OP1 Authorization for the Social Security Administration to Obtain Account Records from a Financial Institution and Request for Records NEW SSA-4641-OP1 Overprint Version.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

125,200 0
   
Individuals or Households
 
   100 %

  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 125,200 0 0 125,200 0 0
Annual IC Time Burden (Hours) 56,340 0 0 56,340 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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