f) State Notification to SSA of Deceased Claimant

SSI Notice of Interim Assistance Reimbursement (IAR)

OMB: 0960-0546

IC ID: 186512

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f) State Notification to SSA of Deceased Claimant
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1920, 416.1922 20 CFR 416.1901-416.1902, 416.1904 20 CFR 416.1906, 416.1908, 416.1910

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Income Security General Retirement and Disability

 

40 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 40 0 0 0 0 40
Annual IC Time Burden (Hours) 10 0 0 0 0 10
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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