Information Collection

Revisions to 0960-0454 SSA-L5061 (Paper Form) based on the NPRM

IC 261643 under ICR 202308-0960-006 · OMB 0960-0831.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0831 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-L5061 Revisions to 0960-0454 SSA-L5061 (Paper Form) based on the NPRM Form
SSA-L5061 Letter To Landlord Requesting Rental Information SSA-L5061 - Current Version.pdf Form
SSA-L5061 Letter To Landlord Requesting Rental Information SSA-L5061 - Current Version.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Revisions to 0960-0454 SSA-L5061 (Paper Form) based on the NPRM	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.1100 20 CFR 416.1101 20 CFR 416.1102 20 CFR 416.1103

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-L5061	Letter To Landlord Requesting Rental Information	SSA-L5061 - Current Version.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35,640	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35,640	35,640
Annual IC Time Burden (Hours)	4,752	4,752
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.