Information Collection

Partnership Questionnaire

IC 8923 under ICR 202012-0960-005 · OMB 0960-0025.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0025 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-7104 Partnership Questionnaire Form
Privacy Act Statement (revised) 0025.docx Other-Revised Privacy Act Statement
Privacy Act Statement (revised) 0025.docx Other-Revised Privacy Act Statement
SSA-7104 Partnership Questionnaire SSA-7104 (revised).pdf www.ssa.gov Form
SSA-7104 Partnership Questionnaire SSA-7104 (revised).pdf www.ssa.gov Form
SSA-7104 (current).pdf Current Version SSA-7104 IC Document
SSA-7104 (current).pdf Current Version SSA-7104 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Partnership Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR Sub K, 404.1080-404.1082(e) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-7104	Partnership Questionnaire	SSA-7104 (revised).pdf	www.ssa.gov	Yes	No	Fillable Printable
Other-Revised Privacy Act Statement			Privacy Act Statement (revised) 0025.docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,350	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12,350	0	12,350
Annual IC Time Burden (Hours)	12,350	6,175	6,175
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current Version SSA-7104	SSA-7104 (current).pdf	12/18/2020

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