Information Collection

Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Program

IC 189136 under ICR 200905-0960-004 · OMB 0960-0184.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-96 BK Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Program	Form
SSA-96 BK Instructions for Completing of Federal Assistance Applic SSA-96 Paper Form.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-96 BK	Instructions for Completing of Federal Assistance Application for SSA Research and Demonstration Grant Programs	SSA-96 Paper Form.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: 20

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	560	560
Annual IC Cost Burden (Dollars)	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.