Request for Program Consultation

Documents and Forms

Document Name Document Type
RPC revised screens.pdf http;//ssahostadmin.ba.ssa.gov/erpctrm Other-RPC Screen Shots

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Program Consultation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.1601 20 CFR 404.1603 20 CFR 404.1615 20 CFR 404.1641-.1661 20 CFR 404.1620 20 CFR 404.1626 20 CFR 404.1633

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-RPC Screen Shots			RPC revised screens.pdf	http;//ssahostadmin.ba.ssa.gov/erpctrm	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,500	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,500	4,500
Annual IC Time Burden (Hours)	2,250	2,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.