Cancellation of Agreement

Consent-Based Social Security Number Verification Service (CBSV)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0760 can be found here:

Documents and Forms

Document Name Document Type
CBSV User Agreement - 10-1-16 Version.doc Other-User Agreement Notice Cancella
CBSV User Agreement - 10-1-14 Version.doc CBSV User Agreement - 10-1-14 Version IC Document

Information Collection (IC) Details

IC Title:	Cancellation of Agreement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-User Agreement Notice Cancellation			CBSV User Agreement - 10-1-16 Version.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: 20	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CBSV User Agreement - 10-1-14 Version	CBSV User Agreement - 10-1-14 Version.doc	04/14/2016

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