APPLICATION TO BE SELECTED AS PAYEE FOR A SUPPLEMENTAL SECURITY INCOME RECIPIENT

ICR 197601-0960-007

OMB: 0960-0125

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0125 197601-0960-007
Historical Active 197511-0960-001
SSA
APPLICATION TO BE SELECTED AS PAYEE FOR A SUPPLEMENTAL SECURITY INCOME RECIPIENT
No material or nonsubstantive change to a currently approved collection   No
Emergency 01/15/1976
Approved with change 01/15/1976
Retrieve Notice of Action (NOA) 01/15/1976
  Inventory as of this Action Requested Previously Approved
11/30/1980 11/30/1980 11/30/1980
500,000 0 500,000
250,000 0 250,000
0 0 0



None
None


No

1
IC Title Form No. Form Name
APPLICATION TO BE SELECTED AS PAYEE FOR A SUPPLEMENTAL SECURITY INCOME RECIPIENT SSA 8040

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 500,000 500,000 0 0 0 0
Annual Time Burden (Hours) 250,000 250,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/15/1976


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