20 CFR 404.2035(d) - Intranet/Field Office Interview

Representative Payment Policies and Administrative Procedures for Imposing Penalties for False or Misleading Statements or Withholding of Information

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0740 can be found here:

Documents and Forms

Document Name Document Type
0740 screenshots.pdf Other-Sample in-office screen shots
sample screen shots.pdf Sample in-office screens (current) IC Document

Information Collection (IC) Details

IC Title:	20 CFR 404.2035(d) - Intranet/Field Office Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.2035(d)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Sample in-office screen shots			0740 screenshots.pdf		Yes	No	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 562,419	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	562,419	19,019	543,400
Annual IC Time Burden (Hours)	46,868	1,585	45,283
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Sample in-office screens (current)	sample screen shots.pdf	11/18/2015

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