Information Collection

Work Activity Report--Employee 20 CFR 404.1520(b), 404.1571-.1576, 404.1584-.1593 and 416.971-.976

IC 8980 under ICR 200603-0960-010 · OMB 0960-0059.

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Information Collection (IC) Details

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IC Title:	Work Activity Report--Employee 20 CFR 404.1520(b), 404.1571-.1576, 404.1584-.1593 and 416.971-.976	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-821-BK				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300,000	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	300,000	300,000
Annual IC Time Burden (Hours)	225,000	225,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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