Employment Relationship Questionnaire

ICR 200609-0960-013

OMB: 0960-0040

Federal Form Document

IC Document Collections
IC ID
Document
Title
Status
8948 Modified
45416 New
45415 New
ICR Details
0960-0040 200609-0960-013
Historical Active 200401-0960-001
SSA
Employment Relationship Questionnaire
Extension without change of a currently approved collection   No
Regular
Approved without change 01/26/2007
Retrieve Notice of Action (NOA) 11/09/2006
This ICR is approved without change. However, SSA will find a more reliable method of keeping track of burden estimates and update them, if necessary, upon next submission.
  Inventory as of this Action Requested Previously Approved
01/31/2010 36 Months From Approved 02/28/2007
16,000 0 47,500
6,666 0 19,792
0 0 0

Form SSA-7160-F4 is used in developing the question of employer-employee relationships, except where the worker is an officer of a corporation. It is an omnibus questionnaire which elicits information for use under both the common-law control test and the occupational group test. This form gathers the information needed for developing the employment relationship, and determining whether a beneficiary is self-employed or an employee. Respondents are beneficiaries questioning their status as employees, and employers.

US Code: 42 USC 405 Name of Law: null
   US Code: 42 USC 410 Name of Law: null
  
None

Not associated with rulemaking

  71 FR 43270 07/31/2006
71 FR 64327 11/01/2006
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 16,000 47,500 0 0 -31,500 0
Annual Time Burden (Hours) 6,666 19,792 0 0 -13,126 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The decrease in the burden hours is due to a decrease in the use of this form. Also, SSA believes that the original estimate was inaccurate, and is now correcting that estimate.

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 liz.davidson@ssa.gov

  No

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.
11/09/2006


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