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Request for Quarters of Coverage Based on Relationship
Request to Resolve Questionable Quarters of Coverage (QC); Request for QC History Based on Relationship
OMB: 0960-0575
IC ID: 46506
OMB.report
SSA
OMB 0960-0575
ICR 200612-0960-005
IC 46506
( )
Documents and Forms
Document Name
Document Type
Form SSA-513
Request for Quarters of Coverage Based on Relationship
Form
SSA-513 Request for Quarters of Coverage Based on Relationship
S513.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request for Quarters of Coverage Based on Relationship
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-513
Request for Quarters of Coverage Based on Relationship
S513.pdf
No
Paper Only
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:
350,000
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
350,000
0
0
350,000
0
0
Annual IC Time Burden (Hours)
11,667
0
0
11,667
0
0
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.