iClaim Applicant After 3rd Party Completion

Social Security Benefits Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0618 can be found here:

Documents and Forms

Document Name Document Type
New Notices to Beneficiaries for 3rd-party iClaim Completion.doc Other-Notices to Beneficiaries with
2009 Notices to Beneficiaries for 3rd-Party iClaim Completion.pdf Current Notice to Beneficiaries for 3rd-Party iClaim Completion IC Document

Information Collection (IC) Details

IC Title:	iClaim Applicant After 3rd Party Completion	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 404.310-.311 20 CFR 404.315-.322 20 CFR 404.330-.333 20 CFR 404.601-.603 20 CFR 404.1501-.1512

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Notices to Beneficiaries with 3rd-party iClaim completion			New Notices to Beneficiaries for 3rd-party iClaim Completion.doc		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350,519	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	350,519	5,252	345,267
Annual IC Time Burden (Hours)	29,210	438	28,772
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current Notice to Beneficiaries for 3rd-Party iClaim Completion	2009 Notices to Beneficiaries for 3rd-Party iClaim Completion.pdf	11/20/2009

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