CHILD CARE DROPOUT QUESTIONNAIRE

ICR 198904-0960-007

OMB: 0960-0474

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
115631 Migrated
ICR Details
0960-0474 198904-0960-007
Historical Active
SSA
CHILD CARE DROPOUT QUESTIONNAIRE
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/20/1989
Retrieve Notice of Action (NOA) 04/24/1989
  Inventory as of this Action Requested Previously Approved
06/30/1992 06/30/1992
2,000 0 0
166 0 0
0 0 0

THE INFORMATION WILL BE USED TO DETERMINE IF AN APPLICANT FOR DISABILITY BENEFITS MAY HAVE CERTAIN COMPUTATION YEARS EXCLUDED FROM T BENEFIT COMPUTATION. THIS WILL RESULT IN A HIGHER BENEFIT AMOUNT. THE RESPONDENTS ARE INDIVIDUALS APPLYING FOR DISABILITY BENEFITS.

None
None


No

1
IC Title Form No. Form Name
CHILD CARE DROPOUT QUESTIONNAIRE SSA-4162

  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 2,000 0 0 2,000 0 0
Annual Time Burden (Hours) 166 0 0 166 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.
04/24/1989


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