Information Collection

Employment Relationship Questionnaire

IC 8948 under ICR 202608-0960-008 · OMB 0960-0040.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-7160-F4 Employment Relationship Questionnaire Employment Relationship Questionnaire	Form
Privacy Act Statement-Revised.docx	Other-Revised PA Statement
SSA-7160-F4 Employment Relationship Questionnaire SSA-7160 - Revised.pdf	Form
SSA-7160 - Revised.pdf SSA-7160 (current)	IC Document

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 404.1007

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-7160-F4			www.ssa.gov	Yes	No	Printable Only
Other-Revised PA Statement					Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	19	-26	45
Annual IC Time Burden (Hours)	32	13	19
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-7160 (current)		08/14/2026

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

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