OMB
.report
Search
Request for Social Security Earnings Information
Request for Social Security Earnings Information
OMB: 0960-0525
IC ID: 9428
OMB.report
SSA
OMB 0960-0525
ICR 202012-0960-001
IC 9428
( )
Documents and Forms
Document Name
Document Type
Form SSA-7050
Request for Social Security Earnings Information
Form
Revised PA & PRA Statements.pdf
Other-Revised PA & PRA Statements
SSA-7050 Request fo Social Security Earning Information
SSA-7050 - Revised.pdf
Form
SSA-7050 - Current.pdf
SSA-7050 - Current
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request for Social Security Earnings Information
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR 401.100
20 CFR 404.810
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-7050
Request fo Social Security Earning Information
SSA-7050 - Revised.pdf
Yes
No
Fillable Printable
Other-Revised PA & PRA Statements
Revised PA & PRA Statements.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
66,800
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
66,800
0
0
0
0
66,800
Annual IC Time Burden (Hours)
12,247
0
0
0
0
12,247
Annual IC Cost Burden (Dollars)
7,147,600
0
0
3,334,839
0
3,812,761
Documents for IC
Title
Document
Date Uploaded
SSA-7050 - Current
SSA-7050 - Current.pdf
12/04/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.