SSA-2 MCS Signature Proxy - In-Office Interview

Social Security Benefits Application

Documents and Forms

Document Name Document Type
MCS screens.pdf Other-Internal Screens

Information Collection (IC) Details

IC Title:	SSA-2 MCS Signature Proxy - In-Office Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.601-404.603 20 CFR 404.1501-404.1512 20 CFR 404.310-404.311 20 CFR 404.315-404.322 20 CFR 404.330-404.333

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Screens			MCS screens.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,227	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	8,227	8,227
Annual IC Time Burden (Hours)	10,421	10,421
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.