Information Collection Request

Statement for Determining Continuing Eligibility for Supplemental Security Income Payment--Adult/Statement for Determining Continuing Eligibility for Supplemental Security Income.....

ICR 200705-0960-008 · OMB 0960-0643 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-3989 Statement for Determining Continuing Eligibility for Supplemental Security Income Payment--Adult/Statement for Determining Continuing Eligibility for Supplemental Security Income..... Form Modified Available
Addendum--0643 (10-25-07 Conference Call).doc Supplementary Document Uploaded 2007-10-25 Available
SSA-3989-OCR-SM-1(orginial).pdf Supplementary Document Uploaded 2007-08-03 Available
SSA-3988-OCR-SM-W-1(orginial).pdf Supplementary Document Uploaded 2007-08-03 Available
3988SPRT STM-2007 08-01-2007[1].doc Supporting Statement A Uploaded 2007-08-03 Available
Revision Document for 3988and3989May15[1].doc Supplementary Document Uploaded 2007-08-01 Available

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2010 36 Months From Approved 12/31/2008
60,000 0 715,000
26,000 0 309,834
0 0 0





table that charts list of burden
  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 60,000 715,000 0 -655,000 0 0
Annual Time Burden (Hours) 26,000 309,834 0 -283,834 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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