OMB control number
Medicare Part B Income-Related Premium -- Life-Changing Event
OMB 0960-0735 · SSA.
OMB 0960-0735
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form SSA-44 Medicare Part B Income-Related Premium -- Life-Changing Event (paper form) | Form and Instruction |
 SSA-44 (0960-0735) addendum 2010 (emergency).doc | Supplementary Document |
| SSA-44 (0960-0735) emergency request clearance letter.doc | Supplementary Document |
| SSA-44 (0960-0735) emergency supporting statement.doc | Supporting Statement A |
 Medicare Part B Income-Related Premium -- Life-Changing Event (screen shots) |
Other-MSSICS Screens |
| Medicare Part B Income-Related Premium -- Life-Changing Event (paper form) |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201006-0960-013 | Revision of a currently approved collection | 2010-06-29 | Approved without change | |
| 200906-0960-001 | Revision of a currently approved collection | 2009-08-23 | Approved without change | |
| 200812-0960-006 | No material or nonsubstantive change to a currently approved collection | 2008-12-10 | Approved without change | |
| 200609-0960-030 | New collection (Request for a new OMB Control Number) | 2006-10-03 | Approved with change |