Record of SSI Inquiry

ICR 199905-0960-003

OMB: 0960-0140

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
9119 Migrated
ICR Details
0960-0140 199905-0960-003
Historical Active 199605-0960-011
SSA
Record of SSI Inquiry
Extension without change of a currently approved collection   No
Regular
Approved without change 08/03/1999
Retrieve Notice of Action (NOA) 05/28/1999
  Inventory as of this Action Requested Previously Approved
09/30/2002 09/30/2002 07/31/1999
2,134,100 0 1,197,900
177,842 0 45,658
0 0 0

Form SSA-3462 is completed by SSA personnel, via telephone or personal interview, and it may be used to determine potential eligibility for SSI benefits. The respondents are individuals who inquire about SSI eligibility for themselves or someone else.

None
None


No

1
IC Title Form No. Form Name
Record of SSI Inquiry SSA-3462

  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 2,134,100 1,197,900 0 0 936,200 0
Annual Time Burden (Hours) 177,842 45,658 0 0 132,184 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.
05/28/1999


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