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Quality Review Questionnaires-insured Individual, Spouse And Surviving Spouse, Children, Aet, And Rsdi
QUALITY REVIEW QUESTIONNAIRES-INSURED INDIVIDUAL, SPOUSE AND SURVIVING SPOUSE, CHILDREN, AET, AND RSDI
OMB: 0960-0189
IC ID: 115022
OMB.report
SSA
OMB 0960-0189
ICR 198007-0960-005
IC 115022
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0189 can be found here:
2024-03-14 - No material or nonsubstantive change to a currently approved collection
2024-01-02 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
QUALITY REVIEW QUESTIONNAIRES-INSURED INDIVIDUAL, SPOUSE AND SURVIVING SPOUSE, CHILDREN, AET, AND RSDI
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-2930,
No
No
Form
2931, 2932,
No
No
Form
4649, &
No
No
Form
1398-F7
No
No
Form
SSA-4659
No
No
Form
SSA-2930
No
No
Form
SSA-2931
No
No
Form
SSA-2932
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
8,950
0
8,950
0
0
0
Annual IC Time Burden (Hours)
4,408
0
4,408
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.