RECONCILIATION STATEMENT

ICR 198201-0960-002

OMB: 0960-0271

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
115161 Migrated
ICR Details
0960-0271 198201-0960-002
Historical Active
SSA
RECONCILIATION STATEMENT
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 03/12/1982
Retrieve Notice of Action (NOA) 01/11/1982
  Inventory as of this Action Requested Previously Approved
03/31/1984 03/31/1984
75 0 0
38 0 0
0 0 0

THE PAYROLL RECORDS OF THE SAMPLE PUBLIC EMPLOYERS ARE EXAMINED TO DETERMINE IF THOSE EMPLOYEES WHO ARE COVERED FOR SOCIAL SECURITY PURPOSES UNDER THEIR CONTRACT WITH THE SECRETARY OF HEALTH AND HUMAN SERVICES ARE CORRECTLY BEING REPORTED AND CONVERSELY THOSE EMPLOYEES WHO ARE NOT COVERED FOR SOCIAL SECURITY PURPOSES ARE NOT BEING REPORTED.

None
None


No

1
IC Title Form No. Form Name
RECONCILIATION STATEMENT SSA-4792, (10-81)

  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 75 0 0 75 0 0
Annual Time Burden (Hours) 38 0 0 38 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
01/11/1982


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