Marital Relationship Questionnaire

Marital Relationship Questionnaire

OMB: 0960-0460

IC ID: 187842

Documents and Forms
Document Name
Document Type
Other-Internal Use Screens
Information Collection (IC) Details

View Information Collection (IC)

Marital Relationship Questionnaire
 
No New
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1826

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internal Use Screens Form SSA 4178 Marriage MSSICS screens.doc Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

1,275 0
   
Individuals or Households
 
   100 %

  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 1,275 0 0 1,275 0 0
Annual IC Time Burden (Hours) 106 0 0 106 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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