Continuation of SSI Benefits for the Temporarily Institutionalized – Certification of Period and Need to Maintain Home

Continuation of Supplemental Security Income Payments for the Temporarily Institutionalized – Certification of Period and Need to Maintain Home

OMB: 0960-0516

IC ID: 9422

Documents and Forms
Document Name
Document Type
Other-MISSICS Screen Used for this C
Information Collection (IC) Details

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Continuation of SSI Benefits for the Temporarily Institutionalized – Certification of Period and Need to Maintain Home
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.212(b)(1)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-MISSICS Screen Used for this Collection Screen Shots for MSSICS LINS Screen.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

60,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 60,000 0 0 0 0 60,000
Annual IC Time Burden (Hours) 5,000 0 0 0 0 5,000
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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