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g) Review/Signing Agreements
SSI Notice of Interim Assistance Reimbursement (IAR)
OMB: 0960-0546
IC ID: 186513
OMB.report
SSA
OMB 0960-0546
ICR 202007-0960-004
IC 186513
( )
Documents and Forms
Document Name
Document Type
Sample MOU Used with States.pdf
Other-MOU
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
g) Review/Signing Agreements
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 416.1901-416.1902, 416.1904
20 CFR 416.1906, 416.1908, 416.1910
20 CFR 416.1920, 416.1922
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-MOU
Sample MOU Used with States.pdf
No
Paper Only
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:
38
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
38
0
0
0
0
38
Annual IC Time Burden (Hours)
456
0
0
0
0
456
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.
