Ssa-9302

Medicare Subsidy Quality Review

OMB: 0960-0707

IC ID: 179406

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

SSA-9302
 
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
Form and Instruction SSA-9302 Notice of Appointment - Reviewer Will Call (Revised) SSA-9302 (revised).pdf No   Paper Only
Instruction SSA-9304(revised).pdf 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) 875 0 0 0 0 875
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current SSA-9302 SSA-9302.pdf 10/04/2017
Current SSA-9304 SSA-9304.pdf 10/04/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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