Information Collection

Certificate of Election for Reduced Spouse's Benefits (Upload Documents)

IC 281296 under ICR 202607-0960-001 · OMB 0960-0398.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-25 (Upload Doc Certificate of Election for Reduced Spouse’s Benefits Certificate of Election for Reduced Spouse's Benefits (Upload Documents)	Form
Privacy Act Statement 0398 (revised).docx	Other-Privacy Act Statement (revised
SSA-25 (Upload Doc Certificate of Election for Reduced Spouse’s Benefits SSA-25 (revised).pdf	Form
SSA-25 (current).pdf SSA-25 (Current)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.421

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-25 (Upload Documents)				Yes	Yes	Fillable Fileable Signable
Other-Privacy Act Statement (revised)					Yes	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 576

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
Annual Number of Responses for this IC	576	576
Annual IC Time Burden (Hours)	605	605
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-25 (Current)		07/01/2026

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].