Information Collection

You Can Make Your Payment by Credit Card--SSA-4589

IC 187022 under ICR 200808-0960-010 · OMB 0960-0462.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0462 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-4589 You Can Make Your Payment by Credit Card--SSA-4589 Form
SSA-4589 Screen Shot.pdf Other-Internal Use Screens
SSA-4589 You Can Make Your Payment by Credit Card SSA-4589-OP1.pdf Form
SSA-4589 Screen Shot.pdf Electronic Screens for the SSA-4589 (internal use only) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	You Can Make Your Payment by Credit Card--SSA-4589	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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-4589	You Can Make Your Payment by Credit Card	SSA-4589-OP1.pdf		No		Paper Only
Other-Internal Use Screens			SSA-4589 Screen Shot.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 36,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	36,500	36,500
Annual IC Time Burden (Hours)	3,042	3,042
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Electronic Screens for the SSA-4589 (internal use only)	SSA-4589 Screen Shot.pdf	04/03/2009

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