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SSA-21 - U.S Resident, MCS Macros Version
Supplement To Claim of Person Outside the United States
OMB: 0960-0051
IC ID: 212849
OMB.report
SSA
OMB 0960-0051
ICR 202103-0960-006
IC 212849
( )
Documents and Forms
Document Name
Document Type
SSA-21 Macros and Script - Revised.docx
Other-Internal Screens
SSA-21 Macros and Script - Current.docx
Other: Internal Screens
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SSA-21 - U.S Resident, MCS Macros Version
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 422.505(b)
20 CFR 404.460
20 CFR 404.463
42 CFR 407.27(c)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Internal Screens
SSA-21 Macros and Script - Revised.docx
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
441
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
441
0
0
-884
0
1,325
Annual IC Time Burden (Hours)
81
0
0
-162
0
243
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Other: Internal Screens
SSA-21 Macros and Script - Current.docx
10/24/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.