Information Collection

Medicare Non-utilization Project (MNUP)

IC 208156 under ICR 202205-0960-005 · OMB 0960-0780.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0780 can be found here:

Documents and Forms

Document Name Document Type
Face-to-Face Interview Worksheet.pdf Other-Interview Worksheet
Face-to-Face Interview Worksheet.pdf Other-Interview Worksheet
Telephone Interview Worksheet.pdf Other-Interview Worksheet
Telephone Interview Worksheet.pdf Other-Interview Worksheet

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medicare Non-utilization Project (MNUP)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 416.204(b) 20 CFR 422.135

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview Worksheet			Face-to-Face Interview Worksheet.pdf		Yes	No	Printable Only
Other-Interview Worksheet			Telephone Interview Worksheet.pdf		Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,210	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,210	-203	4,413
Annual IC Time Burden (Hours)	4,631	3,528	1,103
Annual IC Cost Burden (Dollars)	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.