Information Collection

New Beneficiary Survey

IC 115203 under ICR 198203-0960-008 · OMB 0960-0287.

Documents and Forms

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Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NEW BENEFICIARY SURVEY	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-4787				No	No
Form	(10-81)				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18,000	18,000
Annual IC Time Burden (Hours)	19,440	19,440
Annual IC Cost Burden (Dollars)	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.