Ssa-2931

Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook

Documents and Forms

Document Name Document Type
Form SSA-2931 SSA-2931 Form
Form SSA-2931 SSA-2931 Form
Privacy Act Statement 0960-0189 (revised).docx Other-Privacy Act Statement (revised
Privacy Act Statement 0960-0189 (revised).docx Other-Privacy Act Statement (revised
SSA-2931 RSI/DI QUALITY REVIEW CASE ANALYSIS – AUXILIARY/SURVIVOR SSA-2931 (revised).pdf Form
SSA-2931 RSI/DI QUALITY REVIEW CASE ANALYSIS – AUXILIARY/SURVIVOR SSA-2931 (revised).pdf Form
SSA-2931 (current).pdf SSA-2931 (current) IC Document
SSA-2931 (current).pdf SSA-2931 (current) IC Document

Information Collection (IC) Details

IC Title:	SSA-2931	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-2931	RSI/DI QUALITY REVIEW CASE ANALYSIS – AUXILIARY/SURVIVOR	SSA-2931 (revised).pdf		No		Paper Only
Other-Privacy Act Statement (revised)			Privacy Act Statement 0960-0189 (revised).docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 850	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	850	850
Annual IC Time Burden (Hours)	666	666
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-2931 (current)	SSA-2931 (current).pdf	03/11/2024

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