Authorization for SSA to Obtain Account Records From A Financial Institution And Request for Records - Financial Institutions (Electronic)

Authorization for SSA to Obtain Account Records From A Financial Institution And Request For Records

Documents and Forms

Document Name Document Type

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Information Collection (IC) Details

IC Title:	Authorization for SSA to Obtain Account Records From A Financial Institution And Request for Records - Financial Institutions (Electronic)	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 416.200

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Electronic Screens					Yes	Yes	Fillable Fileable Signable
Other-Electronic Screens					Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 28,503,538	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	28,503,538	13,928,538	14,575,000
Annual IC Time Burden (Hours)	950,118	464,285	485,833
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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

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