Information Collection Request

Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook

ICR 202210-0960-002 · OMB 0960-0189 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SSA-2930 RSI/DI Quality Review Case Analysis - Sampled Number Holder Form Unchanged Available
Form SSA-2930 SSA-2930 Form Unchanged Repair queued
Form SSA-8510 Authorization For The Social Security Administration To Obtain Personal Information Form Unchanged Available
Form SSA-8510 SSA-8510 Form Unchanged Repair queued
Form SSA-2935 Authorization to the Social Security Administration to Obtain Personal Informaition Form and Instruction Unchanged Repair queued
Form SSA-2935 SSA-2935 Form and Instruction Unchanged Repair queued
Form SSA-85 Information Needed to Review Your Social Security Claim Form Unchanged Available
Form SSA-85 SSA-85 Form Unchanged Repair queued
Form SSA-8552 Interview Confirmation Form Unchanged Available
Form SSA-8552 SSA-8552 Form Unchanged Repair queued
Form SSA-4659 Stewardship Annual Earnings Test Workbook Form Modified Available
Form SSA-4659 SSA-4659 Form Modified Repair queued
Form SSA-2931 RSI/DI Quality Review Case Analysis - Auxiliaries/Survivors Form Unchanged Available
Form SSA-2931 SSA-2931 Form Unchanged Repair queued
Justification for Non-Substantive Changes -0189 (Final).docx Justification for No Material/Nonsubstantive Change Uploaded 2022-10-12 Repair queued
Supporting Statement Part B (Final).docx Supporting Statement B Uploaded 2022-07-08 Repair queued
Supporting Statement Part A (Final).docx Supporting Statement A Uploaded 2022-07-08 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
9153 SSA-2930 Form UnchangedRSI/DI Quality Review Case Analysis - Sampled Number Holder
9153 SSA-2930 Form Unchanged
195245 SSA-8510 Form UnchangedAuthorization For The Social Security Administration To Obtain Personal Information
195245 SSA-8510 Form Unchanged
183776 SSA-2935 Form and Instruction UnchangedAuthorization to the Social Security Administration to Obtain Personal Informaition
183776 SSA-2935 Form and Instruction Unchanged
183775 SSA-85 Form UnchangedInformation Needed to Review Your Social Security Claim
183775 SSA-85 Form Unchanged
183774 SSA-8552 Form UnchangedInterview Confirmation
183774 SSA-8552 Form Unchanged
183773 SSA-L8554-U3 Other-Notice Unchanged
183772 SSA-L8553-U3 Other-Notice Unchanged
183771 SSA-L8552-U3 Other-Notice Unchanged
183770 SSA-L8551-U3 Other-Notice Unchanged
183769 SSA-L8550-U3 Other-Notice Unchanged
183268 SSA-4659 Form ModifiedStewardship Annual Earnings Test Workbook
183268 SSA-4659 Form Modified
183268 SSA-4659 Other-Privacy Act Statement (revised) Modified
183264 SSA-2931 Form UnchangedRSI/DI Quality Review Case Analysis - Auxiliaries/Survivors
183264 SSA-2931 Form Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2025 07/31/2025 07/31/2025
18,215 0 18,215
7,686 0 7,686
0 0 0





Reginfo record details
12
table that charts list of burden
IC Title Form No. Form Name
SSA-2930 SSA-2930
SSA-2931 SSA-2931
SSA-2935 SSA-2935
SSA-4659 SSA-4659
SSA-85 SSA-85
SSA-8510 SSA-8510
SSA-8552 SSA-8552
SSA-L8550-U3
SSA-L8551-U3
SSA-L8552-U3
SSA-L8553-U3
SSA-L8554-U3

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 18,215 18,215 0 0 0 0
Annual Time Burden (Hours) 7,686 7,686 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No