20 CFR 416.635(f) - Intranet/Field Office Interview

Representative Payment Policies and Administrative Procedures for Imposing Penalties for False or Misleading Statements or Withholding of Information

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0740 can be found here:

Documents and Forms

Document Name Document Type
0740 screenshots.pdf Other-Sample in-office screen shots
sample screen shots.pdf Sample in-office screens (current) IC Document

Information Collection (IC) Details

IC Title:	20 CFR 416.635(f) - Intranet/Field Office Interview	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 416.635(f)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Sample in-office screen shots			0740 screenshots.pdf		Yes	No	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,067	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,067	103	2,964
Annual IC Time Burden (Hours)	256	9	247
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Sample in-office screens (current)	sample screen shots.pdf	11/18/2015

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