View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

SSA-21 - Non-Resident Alien (not a resident of a tax treaty country), Paper Version
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.460 20 CFR 404.463 20 CFR 422.505(b) 42 CFR 407.27(c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-21 Supplement to Claim of Person Outside the United States SSA-21 (revised).pdf Yes No Fillable Printable
Other-Revised PA Statement 0051 Privacy Act Statement (revised).docx Yes No Fillable Printable
Other-Paper Reduction Act Statement revised 0051 PRA Statement (revised).docx No   Fillable Printable

Income Security General Retirement and Disability

 

1,379 0
   
Individuals or Households
 
   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 1,379 0 0 -456 0 1,835
Annual IC Time Burden (Hours) 184 0 0 -61 0 245
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-21 SSA-21 (current).pdf 04/28/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.