View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Connect Direct Transmission of MER Information (subset of "MER Samples" category)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.1024 20 CFR 404.1519 20 CFR 404.1613 20 CFR 404.1614 20 CFR 404.1624 20 CFR 416.903a 20 CFR 416.912 20 CFR 416.913 20 CFR 416.914 20 CFR 416.917 20 CFR 416.919 20 CFR 416.1013 20 CFR 416.1014 20 CFR 404.1503a 20 CFR 404.1513 20 CFR 404.1514 20 CFR 404.1512 20 CFR 404.1517

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Sample MER Information (same as previous IC, submitted through electronic Connect Direct system)			0960-0555 sample MER forms.pdf	Not through SSA website; sent directly	Yes	Yes	Fillable Fileable Signable

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: 218,400	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	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	218,400	0	0	0	0	218,400
Annual IC Time Burden (Hours)	54,600	0	0	0	0	54,600
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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