Early Use Survey

Accelerated Benefits Demonstration Project

Documents and Forms

Document Name Document Type
Appendix F.doc Other-Advance Letter - Early-Use Sur
Appendix E.pdf NOTE: Completed by interviewer Other-Survey Script (Early-Use Surve

Information Collection (IC) Details

IC Title:	Early Use Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Advance Letter - Early-Use Survey			Appendix F.doc		No		Paper Only
Other-Survey Script (Early-Use Survey)			Appendix E.pdf	NOTE: Completed by interviewer	No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 480	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-480	480
Annual IC Time Burden (Hours)	-240	240
Annual IC Cost Burden (Dollars)	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.