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OMB Control No: 0960-0040	ICR Reference No: 202608-0960-008
Status: Received in OIRA	Previous ICR Reference No: 202404-0960-007
Agency/Subagency: SSA	Agency Tracking No:
Title: Employment Relationship Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 09/28/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2026
Responses	19	45
Time Burden (Hours)	32	19
Cost Burden (Dollars)	0	0

Abstract: When SSA needs to confirm a worker’s employment status to ensure the accuracy of a worker’s earning records, the agency uses Form SSA–7160, Employment Relationship Questionnaire, to determine the existence of an employer-employee relationship. We use the information this form collects to determine whether a beneficiary is self-employed, or if the beneficiary is an employee. The respondents are individuals seeking to establish their status as employees, as well as households, businesses, and state or local governments seeking to establish their status as alleged employers.

Authorizing Statute(s): US Code: 42 USC 410 Name of Law: Social Security Act
US Code: 42 USC 405 Name of Law: Social Security Act

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 48470	07/31/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 60677	09/24/2026
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Employment Relationship Questionnaire	SSA-7160-F4

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	19	45	-26
Annual Time Burden (Hours)	32	19	13
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: When we cleared the this ICR in 2023, the burden was 19 hours. However, we are currently reporting a burden of 8 hours. This change stems from a decrease in the number of responses from 45 to 19. As mentioned in #2 above, it is rare situations when SSA needs information to determine a worker’s employment status. There is no change in the burden time per response. Although the number of responses decreased, SSA did not take any action to cause this change. These figures represent current Management Information data. *Note: The total burden reflected in ROCIS is 32, while the burden cited in #12 of the Supporting Statement is 8. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + telephone call system wait times + a rough estimate of a 30-minute, one-way, drive burden. In contrast, the chart in #12 above reflects actual burden.

Annual Cost to Federal Government: $7,626

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

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