OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

SSA-21 - Non-Resident Alien (not a resident of a tax treaty country), Paper Version

IC 212848 under ICR 202502-0960-012 · OMB 0960-0051.

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

View Information Collection (IC)

SSA-21 - Non-Resident Alien (not a resident of a tax treaty country), Paper Version
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.460 20 CFR 404.463 20 CFR 422.505(b) 42 CFR 407.27(c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-21 Supplement to Claim of Person Outside the United States SSA-21 (revised).pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

570 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 570 0 0 -809 0 1,379
Annual IC Time Burden (Hours) 171 0 0 -13 0 184
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-21 (current) SSA-21 (current).pdf 06/04/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.