Information Collection Request

Statement for Determining Continuing Eligibility for Supplemental Security Income Payments

ICR 201905-0960-003 · OMB 0960-0416 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-8203 Statement Determining Continuing Eligibility for Supplemental Security Income Payments Form Modified Available
Addendum - 0416.docx Supplementary Document Uploaded 2019-08-07 Available
Supporting Statement - 0416.docx Supporting Statement A Uploaded 2019-08-07 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
37987 Statement for determining continuing eligibility for Supplemental Security Income Payments -- MISSIC Screens Signature Proxy Other-Internal Use Screens Removed
178984 Determining Continuing Eligibility for Supplemental Security Income Payments – SSA-8203-BK Form ModifiedStatement Determining Continuing Eligibility for Supplemental Security Income Payments
178983 Statement for Determining Continuing Eligibility for Supplemental Security Income Payments –- SSI Claims System Other-Internal Use Screens Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2022 36 Months From Approved 11/30/2019
1,603,577 0 1,603,577
510,055 0 523,418
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Statement for Determining Continuing Eligibility for Supplemental Security Income Payments –- SSI Claims System
Determining Continuing Eligibility for Supplemental Security Income Payments – SSA-8203-BK SSA-8203
Statement for determining continuing eligibility for Supplemental Security Income Payments -- MISSIC Screens Signature Proxy

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,603,577 1,603,577 0 0 0 0
Annual Time Burden (Hours) 510,055 523,418 0 -13,363 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No