Information Collection

Letter to Landlord Requesting Rental Information

IC 9335 under ICR 202410-0960-012 · OMB 0960-0454.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-L5061 Letter to Landlord Requesting Information Letter to Landlord Requesting Rental Information	Form
SSI Claims System Screens.pdf	Other-Internal Screens
SSI Claims System Screens.pdf	Other-Internal Screens
Alternative language for letter - (Final).docx	Other-Alternative language letter
Alternative language for letter - (Final).docx	Other-Alternative language letter
SSA-L5061 Letter to Landlord Requesting Information SSA-L5061 revised.pdf	Form
SSA-L5061 Letter to Landlord Requesting Information SSA-L5061 revised.pdf	Form
SSA-L5061 - current.pdf Letter to Landlord Requesting Information	IC Document
SSA-L5061 - current.pdf Letter to Landlord Requesting Information	IC Document

IC Title:

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 416.1130(b)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Screens		Yes	Yes	Fillable Fileable
Other-Alternative language letter		No		Paper Only
Form	SSA-L5061	No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 71,280

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	71,280	71,280
Annual IC Time Burden (Hours)	11,880	11,880
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Letter to Landlord Requesting Information		10/18/2024

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

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