Information Collection

Supplemental Security Income-Quality Review Case Analysis

IC 9113 under ICR 201103-0960-001 · OMB 0960-0133.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0133 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-8508-BK Supplemental Security Income-Quality Review Case Analysis	Form
SSA-8508 Letter (revised).pdf	Other-Letter
SSA-8508-BK Supplemental Security Income--Quality Review Case Analys SSA-8508(revised).pdf	Form
SSA-8508(current).pdf SSA-8508 (current)	IC Document
SSA-8508 Letter.pdf SSA-8508 Letter (curent)	IC Document

IC Title:

Supplemental Security Income-Quality Review Case Analysis

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-8508-BK	Supplemental Security Income--Quality Review Case Analysis	SSA-8508(revised).pdf		No		Paper Only
Other-Letter			SSA-8508 Letter (revised).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: 225

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	Previously Approved
Annual Number of Responses for this IC	225	-4,275	4,500
Annual IC Time Burden (Hours)	225	-4,275	4,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-8508 (current)	SSA-8508(current).pdf	04/01/2011
SSA-8508 Letter (curent)	SSA-8508 Letter.pdf	03/28/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.