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Application for Benefits Under a U.S. International Social Security Agreement (Paper)

IC 9326 under ICR 202006-0960-002 · OMB 0960-0448.

Documents and Forms
Document Name
Document Type
Form
Form
Other-Revised PRA Statement
Other-Revised PRA Statement
Form
Form
IC Document
IC Document
Information Collection (IC) Details

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Application for Benefits Under a U.S. International Social Security Agreement (Paper)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1925

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-2490-BK Application for Benefits Under a U.S. International Social Security Agreement SSA-2490-BK - Revised.pdf No   Paper Only
Other-Revised PRA Statement Revised PRA Statement.pdf No   Paper Only

Income Security General Retirement and Disability

 

2,120 0
   
Individuals or Households
 
   0 %

  Approved 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 2,120 0 0 -20 0 2,140
Annual IC Time Burden (Hours) 2,968 0 0 1,898 0 1,070
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-2490-BK - Current SSA-2490-BK - Current.pdf 10/05/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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