Information Collection

Statement for Determining Continuing Eligibility, Supplemental Security Income Payment-- MSSICS SCREENS

IC 45420 under ICR 201001-0960-005 · OMB 0960-0145.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0145 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
MISSICS Screens 8202 08-06.pdf	Other-MSSICS

IC Title:

Statement for Determining Continuing Eligibility, Supplemental Security Income Payment-- MSSICS SCREENS

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 416.204

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
Other-MSSICS			MISSICS Screens 8202 08-06.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 333,408

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	333,408	332,408	1,000
Annual IC Time Burden (Hours)	111,136	110,953	183
Annual IC Cost Burden (Dollars)	0	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.