Statement for determining continuing eligibility for Supplemental Security Income Payments -- MISSIC Screens Signature Proxy

Statement for Determining Continuing Eligibility for Supplemental Security Income Payments

OMB: 0960-0416

IC ID: 37987

Documents and Forms
Document Name
Document Type
Other-Internal Use Screens
Information Collection (IC) Details

View Information Collection (IC)

Statement for determining continuing eligibility for Supplemental Security Income Payments -- MISSIC Screens Signature Proxy
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.204

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internal Use Screens MSSICS Screens - 0416.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

777,085 0
   
Individuals or Households
 
   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 777,085 0 0 745,563 0 31,522
Annual IC Time Burden (Hours) 246,077 0 0 236,095 0 9,982
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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