OMB
.report
Search
Ssa-1002
Statement of Agricultural Employer (Year Prior to 1988; 1988 and Later)
OMB: 0960-0036
IC ID: 8936
OMB.report
SSA
OMB 0960-0036
ICR 202410-0960-001
IC 8936
( )
Documents and Forms
Document Name
Document Type
Form SSA-1002
SSA-1002
Form
SSA-1002 Statement of Agricultural Employer (Years Prior to 1988)
SSA-1002 Revised.pdf
Form
SSA-1002 Current.pdf
Statement of Agricultural Employer (Years Prior to 1988; 1988 and Later)
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SSA-1002
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 404.802
20 CFR 404.702
20 CFR 404.1056
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-1002
Statement of Agricultural Employer (Years Prior to 1988)
SSA-1002 Revised.pdf
Yes
No
Fillable Printable
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:
7,500
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Farms
Percentage of Respondents Reporting Electronically:
0 %
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
7,500
0
0
0
0
7,500
Annual IC Time Burden (Hours)
10,500
0
0
0
0
10,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Statement of Agricultural Employer (Years Prior to 1988; 1988 and Later)
SSA-1002 Current.pdf
10/18/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.