Information Collection

Questionnaire About Special Veterans Benefits

IC 189024 under ICR 200905-0960-009 · OMB 0960-0782.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0782 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-2010 Questionnaire About Special Veterans Benefits	Form
SSA-2010 Cover Letter.pdf	Other-Cover Letter
SSA-2010 Cover Letter - No Response.pdf	Other-Cover Letter
SSA-2010 Questionnaire About Special Veterans Benefits SSA-2010.pdf	Form

IC Title:

Questionnaire About Special Veterans Benefits

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	SSA-2010	Questionnaire About Special Veterans Benefits	SSA-2010.pdf	No	Paper Only
Other-Cover Letter			SSA-2010 Cover Letter.pdf	No	Paper Only
Other-Cover Letter			SSA-2010 Cover Letter - No Response.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: 2,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,500	2,500
Annual IC Time Burden (Hours)	833	833
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.