Ssa-9301

Medicare Subsidy Quality Review

OMB: 0960-0707

IC ID: 9763

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

SSA-9301
 
No Modified
 
Voluntary
 
20 CFR 418(b)(5)  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Telephone Interview Script SSA-9301 Current Version.docx N/A conducted over telephone No   Paper Only

Income Security General Retirement and Disability

 

3,500 0
   
Individuals or Households
 
   0 %

  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 3,500 0 0 0 0 3,500
Annual IC Time Burden (Hours) 1,750 0 0 0 0 1,750
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-9301 Current Version SSA-9301 Current Version.docx 08/08/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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