Letter to Employer Requesting Information About Wages Earned by Beneficiary 20 CFR 404.703, 404.801

Letter to Employer Requesting Information About Wages Earned by Beneficiary

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0034 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-L725 Letter to Employer Requesting Information About Wages Earned by Beneficiary 20 CFR 404.703, 404.801 Form
Revised PA Statement.pdf Other-Revised PA Statement
SSA-L725 Letter to Employer Requesting Information About Wages Ea SSA-L725-F3 - Revised.pdf Form
SSA-L725-F3 - Current.pdf Current SSA-L725 IC Document

Information Collection (IC) Details

IC Title:	Letter to Employer Requesting Information About Wages Earned by Beneficiary 20 CFR 404.703, 404.801	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.801 20 CFR 404.703 20 CFR 404.820

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-L725	Letter to Employer Requesting Information About Wages Earned by Beneficary	SSA-L725-F3 - Revised.pdf		No		Paper Only
Other-Revised PA Statement			Revised PA Statement.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150,000	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	150,000	150,000
Annual IC Time Burden (Hours)	100,000	100,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-L725	SSA-L725-F3 - Current.pdf	11/07/2017

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