SUMMARY REPORT ON CLAIMS OF GOOD CAUSE...AND CASE REPORT ON CLAIM OF GOOD CAUSE

ICR 197909-0960-001

OMB: 0960-0177

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
0960-0177 197909-0960-001
Historical Active
SSA
SUMMARY REPORT ON CLAIMS OF GOOD CAUSE...AND CASE REPORT ON CLAIM OF GOOD CAUSE
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 10/17/1979
Retrieve Notice of Action (NOA) 09/11/1979
  Inventory as of this Action Requested Previously Approved
01/31/1982 01/31/1982
40,068 0 0
7,210 0 0
0 0 0

SECTION 402(A)(26)(B) AND 545(4)(A) AND (B) OF THE SOCIAL SECURITY ACT PROVIDE FOR INFORMATION REQUIRED TO MAINTAIN RECORDS OF ACTIVITIES THAT WILL MAKE IT POSSIBLE TO SUBMIT TO HHS DELINEATED INFORMATION ON GOOD CAUSE CLAIMS IN ADMINISTERING THE AID TO FAMILIES WITH DEPENDENT CHILDREN (AFDC) PROGRAM. THIS FORM ELICITS THE REQUIRED INFORMATION FROM STATES.

None
None


No

1
IC Title Form No. Form Name
SUMMARY REPORT ON CLAIMS OF GOOD CAUSE...AND CASE REPORT ON CLAIM OF GOOD CAUSE SSA-4680, & SSA-4681

  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 40,068 0 0 0 40,068 0
Annual Time Burden (Hours) 7,210 0 0 0 7,210 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.
09/11/1979


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