Information Collection

ASC Internet Screens - Respondent Input

IC 254579 under ICR 202607-0960-008 · OMB 0960-0828.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ASC Screen Package (formerly ESS).pdf	Other-ASC Screen Package
ASC De Minimis Screen Changes.pdf	Other-Revised Internet Screens
ASC - Revised PA Screens.pdf	Other-Revised Privacy Act Statement
Current Privacy Act Screens.pdf Current Privacy Act Statement Screens	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-ASC Screen Package	www.ssa.gov	Yes	Yes	Fillable Fileable
Other-Revised Internet Screens	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Revised Privacy Act Statement	www.ssa.gov	Yes	Yes	Printable Only

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 %

table that charts list of burden
	Requested	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

table that charts IC Documents
Title	Document	Date Uploaded
Current Privacy Act Statement Screens		07/22/2026

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

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