APPLICATIONS FOR EXEMPTION FROM SOCIAL SECURITY COVERAGE FOR CERTAIN MINISTERS, MEMBERS OF RELIGIOUS ORDERS, & CHRISTIAN SCIENCE PRACTITIONERS (TEMP: LR-153-86, NPRM-LR-154-86)
ICR 198708-1545-071
OMB: 1545-0168
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1545-0168 can be found here:
APPLICATIONS FOR EXEMPTION
FROM SOCIAL SECURITY COVERAGE FOR CERTAIN MINISTERS, MEMBERS OF
RELIGIOUS ORDERS, & CHRISTIAN SCIENCE PRACTITIONERS (TEMP:
LR-153-86, NPRM-LR-154-86)
No
material or nonsubstantive change to a currently approved
collection
APPLICANTS MUST CERTIFY THAT THEY HAVE
INFORMED THE CHURCH OR ORDER THAT THEY ARE OPPOSED TO THE
ACCEPTANCE OF CERTAIN PUBLIC INSURANCE BENEFITS AND IT MUST BE
VERIFIED THAT ALL APPLICANTS UNDERSTAND THE GROUNDS FOR EXEMPTION
FROM SOCIAL SECURITY COVERAGE AND THAT THEY SEEK EXEMPTION ON SUCH
GROUNDS UNDER 26 U.S.C. 1402(E).
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.