Questionnaire for Children Claiming SSI Benefits

ICR 200102-0960-010

OMB: 0960-0499

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
9391 Migrated
ICR Details
0960-0499 200102-0960-010
Historical Active 199908-0960-013
SSA
Questionnaire for Children Claiming SSI Benefits
Extension without change of a currently approved collection   No
Regular
Approved without change 04/12/2001
Retrieve Notice of Action (NOA) 02/28/2001
  Inventory as of this Action Requested Previously Approved
05/31/2004 05/31/2004 04/30/2001
272,000 0 132,000
136,000 0 66,000
0 0 0

The information collected on form SSA-3881 is used by Social Security Administration to evaluate disability in children who apply for Supplemental Security Income (SSI) payments. The respondents are individuals who apply for SSI benefits for a disabled child.

None
None


No

1
IC Title Form No. Form Name
Questionnaire for Children Claiming SSI Benefits SSA-3881

  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 272,000 132,000 0 0 140,000 0
Annual Time Burden (Hours) 136,000 66,000 0 0 70,000 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.
02/28/2001


© 2024 OMB.report | Privacy Policy