Notice of Interim Assistance Reimbursement

ICR 199703-0960-002

OMB: 0960-0563

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
9498 Migrated
ICR Details
0960-0563 199703-0960-002
Historical Active 199609-0960-003
SSA
Notice of Interim Assistance Reimbursement
Revision of a currently approved collection   No
Regular
Approved without change 05/08/1997
Retrieve Notice of Action (NOA) 03/11/1997
OMB approves this collection through 10/99 under the following conditions: Upon submission, SSA will provide and electronic version of this form, so state welfare offices can receive and transmit this information electronically.
  Inventory as of this Action Requested Previously Approved
10/31/1999 10/31/1999 05/31/1997
60,000 0 56,000
10,000 0 9,333
0 0 0

The information collected on form SSA-L8125-F6 is used to determine the amount of interim assistance provided to potential beneficiaries by State agencies in order to reimburse the States for such assistance.

None
None


No

1
IC Title Form No. Form Name
Notice of Interim Assistance Reimbursement SSA-L8125-F6

  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 60,000 56,000 0 0 4,000 0
Annual Time Burden (Hours) 10,000 9,333 0 0 667 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.
03/11/1997


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