Information Collection

Beneficiary Interview and Auditor's Observations

IC 9653 under ICR 200702-0960-003 · OMB 0960-0630.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0630 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-322 Beneficiary Interview and Auditor's Observations Form
SSA-322 Beneficiary Interview and Auditor's Observations Beneficiary Interview Observation Form 11-20-03.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Beneficiary Interview and Auditor's Observations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 416.635 20 CFR 404.2035

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-322	Beneficiary Interview and Auditor's Observations	Beneficiary Interview Observation Form 11-20-03.doc		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.