Partnership Questionnaire (completed in or brought to a field office)

Partnership Questionnaire

Documents and Forms

Document Name Document Type
Form SSA-7104 Partnership Questionnaire (completed in or brought to a field office) Form
Privacy Act Statement (revised).docx Other-Privacy Act Statement (revised
Privacy Act Statement (revised).docx Other-Privacy Act Statement (revised
SSA-7104 Partnership Questionnaire SSA-7104 (revised).pdf Form
SSA-7104 Partnership Questionnaire SSA-7104 (revised).pdf Form
SSA-7104 (current).pdf SSA-7104 (current) IC Document
SSA-7104 (current).pdf SSA-7104 (current) IC Document

Information Collection (IC) Details

IC Title:	Partnership Questionnaire (completed in or brought to a field office)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-7104	Partnership Questionnaire	SSA-7104 (revised).pdf		No		Paper Only
Other-Privacy Act Statement (revised)			Privacy Act Statement (revised).docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,154	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2,154	2,154
Annual IC Time Burden (Hours)	3,231	3,231
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-7104 (current)	SSA-7104 (current).pdf	07/03/2024

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