Information Collection

State Agency Report of obligations for SSA Disability Programs--SSA-4513 & SSA-4513-SUP

IC 9273 under ICR 200705-0960-010 · OMB 0960-0421.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-4513 State Agency Report of Obligations for SSA Disability Programs State Agency Report of obligations for SSA Disability Programs--SSA-4513 & SSA-4513-SUP	Form
Form SSA-4513-SUP Supplement State Agency Report of Obligations for SSA Disability Programs State Agency Report of obligations for SSA Disability Programs--SSA-4513 & SSA-4513-SUP	Form
SSA-4513 Instructions.pdf	Instruction
SSA-4513-SUP Instructions.pdf	Instruction
SSA-4513 State Agency Report of Obligations for SSA Disability Pr 4513_form.xls	Form
SSA-4513-SUP Supplement State Agency Report of Obligations for SSA Di 4513SUP.xls	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 404.1626

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Instruction			SSA-4513-SUP Instructions.pdf	No	Fillable Fileable
Form	SSA-4513-SUP	Supplement State Agency Report of Obligations for SSA Disability Programs	4513SUP.xls	No	Fillable Fileable
Instruction			SSA-4513 Instructions.pdf	No	Fillable Fileable
Form	SSA-4513	State Agency Report of Obligations for SSA Disability Programs	4513_form.xls	No	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 52

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	208	0	208
Annual IC Time Burden (Hours)	312	-416	728
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.