View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Statement Regarding Marriage	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.726

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-753	Statement Regarding Marriage	SSA-753 - Revised Version.pdf		Yes	No	Fillable Fileable Signable
Other-Revised PA and PRA Statements			Revised PA and PRA Statements - SSA-753.pdf		Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 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	40,000	0	0	0	0	40,000
Annual IC Time Burden (Hours)	6,000	0	0	0	0	6,000
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current Version of the SSA-753	ssa-753 Form (current).pdf	03/01/2017

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