Information Collection

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

IC 187022 under ICR 202012-0960-014 · OMB 0960-0462.

Documents and Forms

Document Name Document Type
Form SSA-4589 You Can Make Your Payment by Credit Card--Electronic Application SSA-4589 Form
SSA-4589 Credit Card Remittance SSA-4589 (Interview Screens) - Revised.pdf Form
SSA-4589 (Interview Screens) - Current.pdf SSA-4589 (Interview Screens) - Current IC Document

Information Collection (IC) Details

View Information Collection (IC)

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

Is this a Common Form? No		IC Status: Modified

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	Credit Card Remittance	SSA-4589 (Interview Screens) - Revised.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: 258,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	258,500	258,500
Annual IC Time Burden (Hours)	21,542	21,542
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-4589 (Interview Screens) - Current	SSA-4589 (Interview Screens) - Current.pdf	04/28/2021

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