APPLICATION FOR SUPPLEMENTAL SECURITY INCOME (INDIVIDUAL)

ICR 197803-0960-011

OMB: 0960-0122

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0122 197803-0960-011
Historical Active 197703-0960-004
SSA
APPLICATION FOR SUPPLEMENTAL SECURITY INCOME (INDIVIDUAL)
Extension without change of a currently approved collection   No
Regular
Approved without change 03/20/1978
Retrieve Notice of Action (NOA) 03/09/1978
  Inventory as of this Action Requested Previously Approved
01/31/1981 01/31/1981 01/31/1981
604,800 0 800,000
352,800 0 480,000
0 0 0



None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR SUPPLEMENTAL SECURITY INCOME (INDIVIDUAL) SSA-8001

  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 604,800 800,000 0 0 -195,200 0
Annual Time Burden (Hours) 352,800 480,000 0 0 -127,200 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.
03/09/1978


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