Statement for determining continuing eligibility for Supplemental security income payments, 20 CFR 416.204

ICR 200409-0960-006

OMB: 0960-0145

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0960-0145 200409-0960-006
Historical Active 200310-0960-007
SSA
Statement for determining continuing eligibility for Supplemental security income payments, 20 CFR 416.204
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 09/29/2004
Retrieve Notice of Action (NOA) 09/29/2004
  Inventory as of this Action Requested Previously Approved
11/30/2006 11/30/2006 11/30/2006
1,310,000 0 1,720,000
313,000 0 411,333
0 0 0

SSA uses form SSA-8202-BK to conduct low- and middle-error profile (LEP-MEP) telephone or face-to-face redetermination (RZ) interviews with SSI recipients and representative payees. The information is used to determine whether SSI recipients meet all statutory and regulatory requirements for SSI eligibility and whether they have been and are still receiving the correct payment amount. Form SSA-8202-OCR-SM collects similar information to Form SSA-8202-BK; however, it is used exclusively in LEP RZ cases on a 6-year cycle.

None
None


No

1
IC Title Form No. Form Name
Statement for determining continuing eligibility for Supplemental security income payments, 20 CFR 416.204 SSA-8202-BK, SSA-8202-OCR-SM

  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 1,310,000 1,720,000 0 -410,000 0 0
Annual Time Burden (Hours) 313,000 411,333 0 -98,333 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
09/29/2004


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