Application for Supplemental Security Income - 20 CFR, Subpart D, 416.305-.335

ICR 200212-0960-003

OMB: 0960-0444

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0444 200212-0960-003
Historical Active 199909-0960-025
SSA
Application for Supplemental Security Income - 20 CFR, Subpart D, 416.305-.335
Revision of a currently approved collection   No
Regular
Approved with change 02/19/2003
Retrieve Notice of Action (NOA) 12/18/2002
Approved for use through 2/2006 under the condition that SSA amends its PRA disclosure statement to include a solicitation for public comment.
  Inventory as of this Action Requested Previously Approved
04/30/2006 04/30/2006 02/28/2003
872,956 0 1,011,046
219,547 0 252,762
0 0 0

SSA uses the information collected on Form SSA-8001 to determine eligibility for Supplemental Security Income (SSI0 and the amount of benefits payable. The respondents are applicants for SSI benefits.

None
None


No

1
IC Title Form No. Form Name
Application for Supplemental Security Income - 20 CFR, Subpart D, 416.305-.335 SSA-8001

  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 872,956 1,011,046 0 0 -138,090 0
Annual Time Burden (Hours) 219,547 252,762 0 0 -33,215 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.
12/18/2002


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