Information Collection

Statement for Determining Continuing Eligibility for Supplemental Security Income Payments - SSI Claims System

IC 178983 under ICR 202209-0960-003 · OMB 0960-0416.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSI Claims System.pdf	Other-Internal Use Screens

IC Title:

Statement for Determining Continuing Eligibility for Supplemental Security Income Payments Â- SSI Claims System

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 416.204

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-Internal Use Screens			SSI Claims System.pdf		Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,918,702

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,918,702	450,482	1,468,220
Annual IC Time Burden (Hours)	1,566,940	1,102,004	464,936
Annual IC Cost Burden (Dollars)	0	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.