Information Collection

Protection and Advocacy for Beneficiaries of Social Security (PABSS)--Beneficiaries

IC 182006 under ICR 201007-0960-015 · OMB 0960-0768.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0768 can be found here:

Documents and Forms

Document Name Document Type
PABSS Intake Form (Information from Beneficiaries).pdf Other-Beneficiaries Intake

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Protection and Advocacy for Beneficiaries of Social Security (PABSS)--Beneficiaries	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 435.51-435.52

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Beneficiaries Intake			PABSS Intake Form (Information from Beneficiaries).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: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	1,250	1,250
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.