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20 CFR 404.1503b(c) - Fact Sheet
 
No Modified
 
Mandatory
 
20 CFR 416.903b(c) 20 CFR 404.1503b(c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Sample Template www;ssa.gov Yes No Printable Only
Other-Sample Template www.ssa.gov Yes No Printable Only
Other-Sample Template www.ssa.gov Yes No Printable Only

Income Security General Retirement and Disability

 

2,670 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 2,670 0 0 2,070 0 600
Annual IC Time Burden (Hours) 890 0 0 690 0 200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
BBA 812-Paper Fact Sheet-Current 07/05/2026
BBA-812 - Internet Fact Sheet Screen Shots -Current 07/05/2026
Sample Notice for Section 812-Current 07/05/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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