Child Relationship Statement

ICR 199712-0960-004

OMB: 0960-0116

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
9086 Migrated
ICR Details
0960-0116 199712-0960-004
Historical Active 199411-0960-002
SSA
Child Relationship Statement
Extension without change of a currently approved collection   No
Regular
Approved without change 02/12/1998
Retrieve Notice of Action (NOA) 12/17/1997
  Inventory as of this Action Requested Previously Approved
02/28/2001 02/28/2001 02/28/1998
50,000 0 50,000
12,500 0 12,500
0 0 0

The information collected on form SSA-2519 is used to help determine children's entitlement to social security benefits under section 216(h)(3) of the Social Security Act (deemed child provision). The respondents are persons providing information about the relationship between the worker and his/her alleged biological child, in connection with a child's application for benefits.

None
None


No

1
IC Title Form No. Form Name
Child Relationship Statement SSA-2519

  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 50,000 50,000 0 0 0 0
Annual Time Burden (Hours) 12,500 12,500 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.
12/17/1997


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