Supplement to Claim of Person Outside the United States

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0155 can be found here:

Documents and Forms

Document Name Document Type
Form G-45 Supplement to Claim of Person Outside the United States Form and Instruction
G-45 Supplement to Claim of Person Outside the United States Form G-45 (05-13).pdf Form and Instruction
Form SSA-21 (02-2016).pdf SSA-21 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Supplement to Claim of Person Outside the United States	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
Form and Instruction	G-45	Supplement to Claim of Person Outside the United States	Form G-45 (05-13).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: RRB-22, Railroad Retirement, Survivor and Pensioner Benefit System	FR Citation: 79 FR 58874

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-21	Form SSA-21 (02-2016).pdf	10/26/2016

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