Electronic Records Express Third-Party Registration and Request Screens

Electronic Records Express Third-Party

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0767 can be found here:

Documents and Forms

Document Name Document Type
0960-0767 screen shots.doc www.socialsecurity.gov (exact link developed right before goes live) Other-screen shots
PRA Screen Shot.pdf Paperwork Reduction Act IC Document

Information Collection (IC) Details

IC Title:	Electronic Records Express Third-Party Registration and Request Screens	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-screen shots			0960-0767 screen shots.doc	http://www.socialsecurity.gov (exact link developed right before goes live)	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 66,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,640,000	2,561,656	78,344
Annual IC Time Burden (Hours)	44,000	40,083	3,917
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Paperwork Reduction Act	PRA Screen Shot.pdf	07/22/2009

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