Approved for
only one year due to lack of GPEA compliance.
Inventory as of this Action
Requested
Previously Approved
10/31/2007
36 Months From Approved
10/31/2006
756,300
0
756,300
3,265,658
0
2,502,450
0
0
0
The forms are mandated by law for a
petitioning relative to submit an affidavit on their relative's
behalf. The executed form creates a contract between the sponsor
and any entity that provides means-tested benefits.
Experience has shown that
respondents are taking longer to assemble the required documents in
order to properly submit the form than was originally
anticipated.
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.