STATE REPORT OF INCORRECT BENDEX INFORMATION

ICR 199305-0960-003

OMB: 0960-0517

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
115704 Migrated
ICR Details
0960-0517 199305-0960-003
Historical Active
SSA
STATE REPORT OF INCORRECT BENDEX INFORMATION
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/12/1993
Retrieve Notice of Action (NOA) 05/03/1993
  Inventory as of this Action Requested Previously Approved
08/31/1996 08/31/1996
310 0 0
52 0 0
0 0 0

THE INFORMATION COLLECTED ON FORM SSA-1086 WILL BE USED BY THE SOCIAL SECURITY ADMINISTRATION (SSA) TO CORRECT ITS MASTER DATA BASE AND TO FACILITATE THE ELECTRONIC EXCHANGE OF DATA. THE RESPONDENTS WILL BE STATE AGENCIES WHO PROVIDE OR RECEIVE INCORRECT INFORMATION FROM SSA DURING THE BENEFICIARY DATA EXCHANGE OPERATION.

None
None


No

1
IC Title Form No. Form Name
STATE REPORT OF INCORRECT BENDEX INFORMATION SSA-1086

  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 310 0 0 310 0 0
Annual Time Burden (Hours) 52 0 0 52 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.
05/03/1993


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