Information Collection

Prohibition of Payment of SSI Benefits to Fugitive Felons and Parole/Probation Violators

IC 43706 under ICR 202104-0960-004 · OMB 0960-0617.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0617 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSI Claim System Screens - 0617.pdf	Other-SSI Claim System Screens
SSI Claim System Screens - 0617.pdf	Other-SSI Claim System Screens

IC Title:

Prohibition of Payment of SSI Benefits to Fugitive Felons and Parole/Probation Violators

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(o)

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			SSI Claim System Screens - 0617.pdf		Yes	No	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.