This information
collection is approved under the condition that SSA provide OMB a
copy of the SSA-8001-F5 with the revisions requested by SSA in
their addendum to this clearance as soon as the new version of the
form is printed.
Inventory as of this Action
Requested
Previously Approved
08/31/1992
08/31/1992
07/31/1989
760,000
0
1,077,000
126,667
0
179,500
0
0
0
THE INFORMATION IS USED TO MAKE A
DETERMINATION OF ELIGIBILITY FOR SUPPLEMENTAL SECURITY INCOME (SSI)
PAYMENTS. THE RESPONDENTS ARE APPLICANTS FOR SSI PAYMENTS WHO NEED
TO ESTABLISH NONDISABILITY REQUIREMENTS, ONLY.
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.