Information Collection

ASC Internet Screens - Respondent Input

IC 254579 under ICR 202605-0960-004 · OMB 0960-0828.

Documents and Forms

Document Name Document Type
ASC Screen Package (formerly ESS).pdf www.ssa.gov Other-ASC Screen Package
ASC Screen Package (formerly ESS).pdf www.ssa.gov Other-ASC Screen Package
ASC De Minimis Screen Changes.pdf www.ssa.gov Other-Revised Internet Screens
ASC De Minimis Screen Changes.pdf www.ssa.gov Other-Revised Internet Screens

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ASC Internet Screens - Respondent Input	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-ASC Screen Package			ASC Screen Package (formerly ESS).pdf	www.ssa.gov	Yes	Yes	Fillable Fileable
Other-Revised Internet Screens			ASC De Minimis Screen Changes.pdf	www.ssa.gov	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: 3,000,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 21 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,000,000	3,000,000
Annual IC Time Burden (Hours)	250,000	250,000
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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