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Partnership Questionnaire (mailed)
Partnership Questionnaire
OMB: 0960-0025
IC ID: 8923
OMB.report
SSA
OMB 0960-0025
ICR 202404-0960-012
IC 8923
( )
Documents and Forms
Document Name
Document Type
Form SSA-7104
Partnership Questionnaire (mailed)
Form
Privacy Act Statement (revised).docx
Other-Revised Privacy Act Statement
Privacy Act Statement (revised).docx
Other-Revised Privacy Act Statement
SSA-7104 Partnership Questionnaire
SSA-7104 (revised).pdf
www.ssa.gov
Form
SSA-7104 Partnership Questionnaire
SSA-7104 (revised).pdf
www.ssa.gov
Form
SSA-7104 (current).pdf
SSA-7104 (current)
IC Document
SSA-7104 (current).pdf
SSA-7104 (current)
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Partnership Questionnaire (mailed)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR Sub K, 404.1080-404.1082(e) (To search for a specific CFR, visit the
Code of Federal Regulations.
)
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
www.ssa.gov
Yes
No
Fillable Printable
Other-Revised Privacy Act Statement
Privacy Act Statement (revised).docx
No
Paper Only
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:
4,308
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
4,308
0
0
-8,042
0
12,350
Annual IC Time Burden (Hours)
2,154
0
0
-10,196
0
12,350
Annual IC Cost Burden (Dollars)
0
0
0
0
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.