ANNUAL EARNINGS TEST DIRECT MAIL FOLLOWUP PROGRAM EVALUATION QUESTIONNAIRE

ICR 198410-0960-006

OMB: 0960-0386

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0960-0386 198410-0960-006
Historical Active
SSA
ANNUAL EARNINGS TEST DIRECT MAIL FOLLOWUP PROGRAM EVALUATION QUESTIONNAIRE
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 11/13/1984
Retrieve Notice of Action (NOA) 10/10/1984
APPROVED WITH THE FOLLOWING CONDITION:HHS WILL SUBMIT TO OMB A COPY OF THE RESULTS OF THIS SURVEY.
  Inventory as of this Action Requested Previously Approved
08/31/1985 08/31/1985
2,000 0 0
500 0 0
0 0 0

THE INFORMATION COLLECTED IS NEEDED TO DETERMINE THE EFFECTIVENESS OF THE ANNUAL EARNINGS TEST (AET) DIRECT MAIL FOLLOWUP PROGRAM NOTICES. THE INFORMATION WILL BE USED TO IMPROVE THE AET DIRECT MAIL FOLLOWUP PROGRAM. THE AFFECTED PUBLIC IS COMPRISED OF BENEFICIARIES WHO RECEIVED THE FOLLOWUP PROGRAM NOTICES.

None
None


No

1
IC Title Form No. Form Name
ANNUAL EARNINGS TEST DIRECT MAIL FOLLOWUP PROGRAM EVALUATION QUESTIONNAIRE

  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 2,000 0 0 2,000 0 0
Annual Time Burden (Hours) 500 0 0 500 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/10/1984


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