Information Collection

Technical Updates to Applicability of the Supplemental Security Income (SSI) Reduced Benefit Rate for Individuals Residing in Medical Treatment Facilities

IC 179178 under ICR 201905-0960-006 · OMB 0960-0758.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0758 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Institution Residence - SSI Claim System Screens and Revised PA Statement.pdf	Other-SSI Claim System Screens
Institution Residence - Current MSSICS and SSI Claims System Screens.pdf Currently Approved MSSICS Screens	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Technical Updates to Applicability of the Supplemental Security Income (SSI) Reduced Benefit Rate for Individuals Residing in Medical Treatment Facilities

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 416.708(k)

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
Other-SSI Claim System Screens			Institution Residence - SSI Claim System Screens and Revised PA Statement.pdf		Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 34,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	34,200	34,200
Annual IC Time Burden (Hours)	3,990	3,990
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Currently Approved MSSICS Screens	Institution Residence - Current MSSICS and SSI Claims System Screens.pdf	08/02/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.