Information Collection

International Direct Deposit

IC 9739 under ICR 200701-0960-010 · OMB 0960-0686.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0686 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-1199(Canada) International Direct Deposit Form
SSA-1199(Canada) Direct Deposit Sign-Up Form (Canada) Sample Revised SSA-1199(Canada).doc Form
SSA-1199-XXXX Direct Deposit Sign-Up Form SSA-1199 AnyCountry032607.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	International Direct Deposit	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 31 CFR 210

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-1199(Canada)	Direct Deposit Sign-Up Form (Canada)	Sample Revised SSA-1199(Canada).doc		No		Paper Only
Form	SSA-1199-XXXX	Direct Deposit Sign-Up Form	SSA-1199 AnyCountry032607.doc		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	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	5,000	5,000
Annual IC Time Burden (Hours)	417	417
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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