OMB
.report
Search
Beneficiary Interview and Auditor's Observations
Beneficiary Interview and Auditor's Observations
OMB: 0960-0630
IC ID: 9653
OMB.report
SSA
OMB 0960-0630
ICR 200702-0960-003
IC 9653
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0630 can be found here:
2016-03-02 - Revision of a currently approved collection
2013-04-23 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form SSA-322
Beneficiary Interview and Auditor's Observations
Form
SSA-322 Beneficiary Interview and Auditor's Observations
Beneficiary Interview Observation Form 11-20-03.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Beneficiary Interview and Auditor's Observations
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR 416.635
20 CFR 404.2035
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-322
Beneficiary Interview and Auditor's Observations
Beneficiary Interview Observation Form 11-20-03.doc
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
200
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
200
0
0
0
0
200
Annual IC Time Burden (Hours)
50
0
0
0
0
50
Annual IC Cost Burden (Dollars)
0
0
0
0
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.