WORKSEET FOR INTEGRATED AFDC, FOOD STAMPS AND MEDICAID QUALITY CONTROL REVIEWS

ICR 198208-0960-001

OMB: 0960-0176

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
0960-0176 198208-0960-001
Historical Active 198112-0960-009
SSA
WORKSEET FOR INTEGRATED AFDC, FOOD STAMPS AND MEDICAID QUALITY CONTROL REVIEWS
Revision of a currently approved collection   No
Regular
Approved without change 09/10/1982
Retrieve Notice of Action (NOA) 08/16/1982
  Inventory as of this Action Requested Previously Approved
05/31/1985 05/31/1985 12/31/1983
80,581 0 30,636
849,228 0 247,226
0 0 0

USE OF THIS FORM IS A MAJOR MANAGEMENT TOOL IN SSA FOR OBTAINING A MEASUREMENT OF ALL PAYMENTS MADE AND PROVIDING DATA AND ANALYSIS TO HE OPERATIONS MANAGERS IMPROVE PAYMENT ACCURACY.

None
None


No

1
IC Title Form No. Form Name
WORKSEET FOR INTEGRATED AFDC, FOOD STAMPS AND MEDICAID QUALITY CONTROL REVIEWS SSA-4340, (7-82)

  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 80,581 30,636 0 49,945 0 0
Annual Time Burden (Hours) 849,228 247,226 0 602,002 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.
08/16/1982


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