Information Collection

Workseet For Integrated Afdc, Food Stamps And Medicaid Quality Control Reviews

IC 114995 under ICR 198208-0960-001 · OMB 0960-0176.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0176 can be found here:

Documents and Forms

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Information Collection (IC) Details

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

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80,581	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	Previously Approved
Annual Number of Responses for this IC	80,581	49,945	30,636
Annual IC Time Burden (Hours)	849,228	602,002	247,226
Annual IC Cost Burden (Dollars)	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.