STATEMENT FOR DETERMINING CONTINUING ELIGIBILITY FOR SUPPLEMENTAL SECURITY INCOME PAYMENTS

ICR 199105-0960-007

OMB: 0960-0416

Federal Form Document

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ICR Details
0960-0416 199105-0960-007
Historical Active 199102-0960-006
SSA
STATEMENT FOR DETERMINING CONTINUING ELIGIBILITY FOR SUPPLEMENTAL SECURITY INCOME PAYMENTS
No material or nonsubstantive change to a currently approved collection   No
Emergency 05/07/1991
Approved with change 05/07/1991
Retrieve Notice of Action (NOA) 05/07/1991
  Inventory as of this Action Requested Previously Approved
03/31/1992 03/31/1992 03/31/1992
554,000 0 554,000
110,800 0 110,800
0 0 0

THE INFORMATION COLLECTED BY THE SSA-8203-BK WILL BE USED BY THE SOCIAL SECURITY ADMINISTRATION TO HELP DETERMINE IF AN INDIVIDU CURRENTLY RECEIVING SUPPLEMENTAL SECURITY INCOME BENEFITS (SSI) SHOULD CONTINUE RECEIVING THOSE PAYMENTS. THE AFFECTED PUBLIC CONSISTS OF CERTAIN CATEGORIES OF INDIVIDUALS CURRENTLY RECEIVING SSI BENEFITS. BECAUSE OF A SCHEDULED REDETERMINATION, OR BECAUSE AN EVENT OCCURRED

None
None


No

1
IC Title Form No. Form Name
STATEMENT FOR DETERMINING CONTINUING ELIGIBILITY FOR SUPPLEMENTAL SECURITY INCOME PAYMENTS SSA-8203

  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 554,000 554,000 0 0 0 0
Annual Time Burden (Hours) 110,800 110,800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
05/07/1991


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