Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
SSA-821-BK - Electronic New 25320 25320 0 Form SSA-821-APP Work Activity Report – Employee
Other-Revised Privacy Act and PRA Statements
SSA-821-BK - In Office Responses Modified 64330 106145 0 Form SSA-821-BK Work Activity Report – Employee
Other-Revised Privacy Act and PRA Statements
SSA-821-BK - Returned Via Mail New 192990 176908 0 Form SSA-821-BK Work Activity Report – Employee
Other-Revised Privacy Act and PRA Statements
SSA-821-BK - Telephone Interview New 128660 137237 0 Form SSA-821-BK Work Activity Report – Employee
Other-Revised Privacy Act and PRA Statements
Total burden requested under this ICR: 411300 445610 0  
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