Ssa-2960

Application for Benefits Under a U.S. International Social Security Agreement

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0448 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-2960 SSA-2960 Form and Instruction
SSA-2960 U.S - [Country] Agreement on Social Security Transmittal SSA-2960.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	SSA-2960	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.1925

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-2960	U.S - [Country] Agreement on Social Security Transmittal/Request/Certification	SSA-2960.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-11,000	11,000
Annual IC Time Burden (Hours)	-550	550
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.