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Federal forms, ICRs, and supporting documents

Information Collection

Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements

IC 13834 under ICR 202306-1240-003 · OMB 1240-0016.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 10.528

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CA-1032 Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlement Request for Information on Earnings Dual Benefits Dependents and Third Party Settlement (CA-1032) expiration 11.30.2023.docx https://www.ecomp.dol.gov Yes Yes Fillable Printable

Income Security General Retirement and Disability

DOL/GOVT-1  81 FR 47418

33,372 0
   
Individuals or Households
 
   31 %

  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 33,372 0 0 -3,684 0 37,056
Annual IC Time Burden (Hours) 11,013 0 0 -1,215 0 12,228
Annual IC Cost Burden (Dollars) 15,198 0 0 168 0 15,030

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