OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs, 20 CFR 418.3125

IC 9780 under ICR 200706-0960-006 · OMB 0960-0723.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs, 20 CFR 418.3125
 
No Modified
 
Voluntary
 
20 CFR 418.3125

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction New SSA-1026-OCR-SM-REDE Statement for Continuing Eligibility for Extra Help with Medicare Prescription Drug Plan Costs New SSA-1026-REDE.pdf No   Paper Only
Form and Instruction SSA-1026B-OCR-SM Social Security Administration Review of Your Eligibility for Extra Help SSA-1026B-OCR-SM.pdf No   Paper Only
Form and Instruction SSA-1026-OCR-SCR Statement for Continuing Eligibility for Extra Help with Medicare Prescription Drug Plan Costs (Reporting A Change That May Affect Your Extra Help) SSA-1026-OCR-SCE.pdf No   Paper Only

Income Security General Retirement and Disability

 

1,876,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,876,000 0 0 0 0 1,876,000
Annual IC Time Burden (Hours) 250,333 0 0 0 0 250,333
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Statement for Continuing Eligibility for Extra Help with Medicare Prescription Drug Plan Costs SSA-1026-OCR-SCE.pdf 06/25/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.