Information Collection

SSA- 1026-REDE SSA Review of Your Eligibility for Extra Help

IC 9780 under ICR 201408-0960-003 · OMB 0960-0723.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0723 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form New SSA-1026-OCR-S SSA- 1026-REDE SSA Review of Your Eligibility for Extra Help	Form and Instruction
New SSA-1026-OCR-S SSA Review of Your Eligibility for Extra Help SSA-1026-REDE.pdf	Form and Instruction

IC Title:

SSA- 1026-REDE SSA Review of Your Eligibility for Extra Help

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 418.3125

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 and Instruction	New SSA-1026-OCR-SM-REDE	SSA Review of Your Eligibility for Extra Help	SSA-1026-REDE.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: 104,194

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	104,194	-120,806	225,000
Annual IC Time Burden (Hours)	31,258	-36,242	67,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.