SSA-21 - Non-Resident Alien (not a resident of a tax treaty country), MCS Macros Version

Supplement To Claim of Person Outside the United States

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0051 can be found here:

Documents and Forms

Document Name Document Type
SSA-21 Macros and Script - Revised.docx Other-Internal Screens
SSA-21 Macros and Script - Current.docx Other: Internal Screens IC Document

Information Collection (IC) Details

IC Title:	SSA-21 - Non-Resident Alien (not a resident of a tax treaty country), MCS Macros Version	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 404.463 20 CFR 422.505(b) 42 CFR 407.27(c) 20 CFR 404.460

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Screens			SSA-21 Macros and Script - Revised.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,769	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,769	-2,640	7,409
Annual IC Time Burden (Hours)	397	-220	617
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Other: Internal Screens	SSA-21 Macros and Script - Current.docx	10/24/2017

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