Information Collection Request

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

ICR 202502-0960-005 · OMB 0960-0189 · 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 Modified Available
Form SSA-2930 SSA-2930 Form Modified Repair queued
Form SSA-8510 Authorization For The Social Security Administration To Obtain Personal Information Form Modified Available
Form SSA-8510 SSA-8510 Form Modified Missing upstream
Form SSA-2935 Authorization to the Social Security Administration to Obtain Personal Informaition Form and Instruction Modified Available
Form SSA-2935 SSA-2935 Form and Instruction Modified Repair queued
Form SSA-85 Information Needed to Review Your Social Security Claim Form Modified Available
Form SSA-85 SSA-85 Form Modified Repair queued
Form SSA-8552 Interview Confirmation Form Modified Available
Form SSA-8552 SSA-8552 Form Modified 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 – AUXILIARY/SURVIVOR Form Modified Available
Form SSA-2931 SSA-2931 Form Modified Repair queued
PC_202502-0960-005_071725_083841_1.pdf Public Comments Uploaded 2025-07-17 Repair queued
Addendum - 0189 (Final).docx Supplementary Document Uploaded 2025-06-27 Repair queued
Addendum - 0189 (Final).docx Supplementary Document Uploaded 2025-06-27 Repair queued
Supporting Statement Part B - 0189 (Final).docx Supporting Statement B Uploaded 2025-06-27 Repair queued
Supporting Statement Part B - 0189 (Final).docx Supporting Statement B Uploaded 2025-06-27 Missing upstream
Supporting Statement Part A - 0189 (Final).docx Supporting Statement A Uploaded 2025-06-27 Repair queued
Supporting Statement Part A - 0189 (Final).docx Supporting Statement A Uploaded 2025-06-27 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
9153 SSA-2930 Form ModifiedRSI/DI Quality Review Case Analysis - Sampled Number Holder
9153 SSA-2930 Form Modified
195245 SSA-8510 Form ModifiedAuthorization For The Social Security Administration To Obtain Personal Information
195245 SSA-8510 Form Modified
183776 SSA-2935 Form and Instruction ModifiedAuthorization to the Social Security Administration to Obtain Personal Informaition
183776 SSA-2935 Form and Instruction Modified
183776 SSA-2935 Other-Revised Privacy Act and PRA Statements Modified
183775 SSA-85 Form ModifiedInformation Needed to Review Your Social Security Claim
183775 SSA-85 Form Modified
183775 SSA-85 Other-Revised Privacy Act and PRA Statements Modified
183774 SSA-8552 Form ModifiedInterview Confirmation
183774 SSA-8552 Form Modified
183774 SSA-8552 Other-Revised Privacy Act and PRA Statements Modified
183773 SSA-L8554 Other-Notice Modified
183772 SSA-L8553 Other-Notice Modified
183771 SSA-L8552-U3 Other-Notice Removed
183770 SSA-L8551-U3 Other-Notice Removed
183769 SSA-L8550-U3 Other-Notice Removed
183268 SSA-4659 Form ModifiedStewardship Annual Earnings Test Workbook
183268 SSA-4659 Form Modified
183268 SSA-4659 Other-Revised Privacy Act and PRA Statements Modified
183264 SSA-2931 Form ModifiedRSI/DI QUALITY REVIEW CASE ANALYSIS – AUXILIARY/SURVIVOR
183264 SSA-2931 Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2028 36 Months From Approved 07/31/2025
17,700 0 18,215
55,582 0 7,686
0 0 0





Reginfo record details
9
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
SSA-L8554

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 17,700 18,215 0 -515 0 0
Annual Time Burden (Hours) 55,582 7,686 0 -189 48,085 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No