REPORT BY PERSON ENTITLED TO SPECIAL AGE 72 PAYMENTS

ICR 198608-0960-017

OMB: 0960-0094

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
166550 Migrated
ICR Details
0960-0094 198608-0960-017
Historical Active 198411-0960-002
SSA
REPORT BY PERSON ENTITLED TO SPECIAL AGE 72 PAYMENTS
No material or nonsubstantive change to a currently approved collection   No
Emergency 08/24/1986
Approved with change 08/24/1986
Retrieve Notice of Action (NOA) 08/24/1986
  Inventory as of this Action Requested Previously Approved
10/31/1987 10/31/1987 10/31/1987
7,000 0 14,000
350 0 700
0 0 0

THE INFORMATION COLLECTED BY THE USE OF FORM SSA-1625 IS NEEDED TO DETERMINE THE CONTINUING ELIGIBILITY OF AN INDIVIDUAL WHO IS RECEIVING SPECIAL AGE 72 PAYMENTS. THE AFFECTED PUBLIC IS COMPRISED OF INDIVIDUALS WHO HAVE EVENTS TO REPORT, WHICH MAY AFFECT THEIR SPECIAL AGE 72 PAYMENTS.

None
None


No

1
IC Title Form No. Form Name
REPORT BY PERSON ENTITLED TO SPECIAL AGE 72 PAYMENTS SSA-1625

  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 7,000 14,000 0 -7,000 0 0
Annual Time Burden (Hours) 350 700 0 -350 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
08/24/1986


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