Information Collection

Application for Benefits Under the Italy-U.S. International Social Security Agreements

IC 9322 under ICR 202608-0960-003 · OMB 0960-0445.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-2528-IT Application for Benefits Under the Italy-U.S. International Social Security Agreement Application for Benefits Under the Italy-U.S. International Social Security Agreements	Form and Instruction
SSA-2528-IT Application for Benefits Under the Italy-U.S. Internatio SSA-2528-IT.pdf www.ssa.gov/international/Agreement	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.1925

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 and Instruction	SSA-2528-IT			http://www.ssa.gov/international/Agreement	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 462

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	462	462
Annual IC Time Burden (Hours)	154	154
Annual IC Cost Burden (Dollars)	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.

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