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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
MISSICS Screens 8202 08-06.pdf Other-MSSICS

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.