Information Collection

Statement for Determining Continuing Eligibility for Supplemental Security Income Payments MISSIC Screens

IC 178983 under ICR 201807-0960-012 · OMB 0960-0416.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0416 can be found here:

Documents and Forms

Document Name Document Type
MSSICS Screens - 0416.pdf Other-Internal Use Screens

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement for Determining Continuing Eligibility for Supplemental Security Income Payments MISSIC Screens	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.204

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Use Screens			MSSICS Screens - 0416.pdf		Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 801,789	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	801,789	801,789
Annual IC Time Burden (Hours)	267,263	267,263
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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