OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Statement of Claimant or Other Person (Telephone interviews)

IC 250002 under ICR 202502-0960-016 · OMB 0960-0045.

Documents and Forms
Document Name
Document Type
Other-SSI Claim System Remarks Scree
Other-SSI Claim System Remarks Scree
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Statement of Claimant or Other Person (Telephone interviews)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.702 20 CFR 416.570

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-SSI Claim System Remarks Screen Revised CCE Screen package for SSA-795 - 5-5-22.pdf Yes Yes Fillable Fileable

Income Security General Retirement and Disability

 

22,516 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 22,516 0 0 -2,067 0 24,583
Annual IC Time Burden (Hours) 6,755 0 0 609 0 6,146
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSI Claim System Remarks Screen SSA-795 screen package (current).docx 11/02/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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