Internet Request for Replacement SSA-1099/1042S

Internet Request for Replacement of Form SSA-1099/SSA-1042S

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0583 can be found here:

Documents and Forms

Document Name Document Type
Screens for Internet Request for Replacement of Forms SSA-1099 or SSA-1042S.pdf s044a90.ssa.gov/apps6z/i1099/main.html Other-Internet Screens for Request f
Block Access Revision--0583.pdf Other-Revision Screens for Internet

Information Collection (IC) Details

IC Title:	Internet Request for Replacement SSA-1099/1042S	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 401.45

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens for Request for Replacement of Forms SSA-1099/SSA-1042S			Screens for Internet Request for Replacement of Forms SSA-1099 or SSA-1042S.pdf	https://s044a90.ssa.gov/apps6z/i1099/main.html	Yes	Yes	Fillable Fileable Signable
Other-Revision Screens for Internet Request for Replacement of Forms SSA-1099/SSA-1042S			Block Access Revision--0583.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 21,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	21,000	0	21,000
Annual IC Time Burden (Hours)	3,500	2,975	525
Annual IC Cost Burden (Dollars)	0	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.