DECOR Notice One-Time Study

SSA-L2765, Request for Self-Employment Information, SSA-L3365, Request for Employee Information, SSA-L4002, Request for Employer Information

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0508 can be found here:

Documents and Forms

Document Name Document Type
DECOR Study OQP Ltr.doc Other-Revised Notice
DECOR Study Wage Report Questionnaire.doc Other-Questionnaire
DECOR Study Earnings Report Questionnaire.doc Other-Questionnaire

Information Collection (IC) Details

IC Title:	DECOR Notice One-Time Study	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Revised Notice	DECOR Study OQP Ltr.doc	No	Paper Only
Other-Questionnaire	DECOR Study Wage Report Questionnaire.doc	No	Paper Only
Other-Questionnaire	DECOR Study Earnings Report Questionnaire.doc	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	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.