Certificate of Coverage Request via Internet - Employers in Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay)

Certificate of Coverage Request

OMB: 0960-0554

IC ID: 206903

Documents and Forms
Document Name
Document Type
Other-Internet Application
Other-Internet Application
Other- Totalization Agreements Unifi
Other- Totalization Agreements Unifi
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Certificate of Coverage Request via Internet - Employers in Denmark, Iceland, Netherlands, Norway, Slovenia, Sweden & Uruguay)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.1913

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internet Application Screen Shot Template for Denmark-Iceland-Netherlands-Norway-Sweden.pdf http://www.ssa.gov/international/totalization_agreements.html Yes Yes Fillable Fileable Signable
Other- Totalization Agreements Unified Webpage Screen Shot Totalization Agreements Unified Webpage Screen Shot.docx Yes Yes Fillable Fileable

Income Security General Retirement and Disability

 

1,937 0
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,937 0 0 0 0 1,937
Annual IC Time Burden (Hours) 1,420 0 0 0 0 1,420
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Certificate of Coverage Certificate of Coverage Internet Request - Denmark.pdf 09/21/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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