Record of SSI Inquiry

Record of Supplemental Security Income Inquiry

Documents and Forms

Document Name Document Type
Form SSA-3462 Record of SSI Inquiry Form
SSA-3462 Record of Supplemental Security Income Inquiry--MSSICS S MSSICS Screens for SSA-3462.pdf Form
SSA-3462 Record of Supplemental Security Income Inquiry SSA-3462.pdf Form

Information Collection (IC) Details

IC Title:	Record of SSI Inquiry	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.345

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-3462	Record of Supplemental Security Income Inquiry--MSSICS Screens	MSSICS Screens for SSA-3462.pdf		Yes	Yes	Fillable Fileable Signable
Form	SSA-3462	Record of Supplemental Security Income Inquiry	SSA-3462.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,800,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,800,000	-334,100	2,134,100
Annual IC Time Burden (Hours)	150,000	-27,842	177,842
Annual IC Cost Burden (Dollars)	0	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.