Revoking Authorization

Authorization for the Social Security Administration to Obtain Wage and Employment Information from Payroll Data Providers

OMB: 0960-0807

IC ID: 226074

Documents and Forms
Document Name
Document Type
Other-Internet Screens
Other-Payroll Data Release Form Scre
Information Collection (IC) Details

View Information Collection (IC)

Revoking Authorization
 
No Removed
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internet Screens BBA 824 Intranet Final Screen Package OMB version 05182017.docx Yes Yes Fillable Fileable Signable
Other-Payroll Data Release Form Screen iClaim Screen for OMB 021517 (3).docx Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

191,673 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 0 -191,673 0 191,673
Annual IC Time Burden (Hours) 0 0 0 -31,946 0 31,946
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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