This information
collection is approved through 8-93 under the following condition:
SSA will reestimate the burden associated with this submission, as
10 minutes does not accurately reflect the time it would take a
respondent to complete the form. OMB recommends that the burden
estimate be revised to at least 15 minutes. The burden disclosure
statement appearing on the revised form must reflect the new
estimate. Additionally, SSA must submit an inventory correction
worksheet to OMB reflecting the reestimated burden.
Inventory as of this Action
Requested
Previously Approved
08/31/1993
08/31/1993
08/31/1992
1,090,000
0
760,000
181,667
0
126,667
0
0
0
THE INFORMATION COLLECTED ON THIS FORM
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 ELIGIBILITY
REQUIREMENTS.
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.