Statement for determining continuing eligibility for Supplemental Security Income Payments -- MISSIC Screens Signature Proxy

Statement for Determining Continuing Eligibility for Supplemental Security Income Payments, 20 CFR 416.204

⚠️ Notice: This information collection may be referencing outdated material.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
MISSICS_Screens_8203_02-26-07 Signature Proxy.pdf Other-MISSICS Screens Signature Prox

Information Collection (IC) Details

IC Title:	Statement for determining continuing eligibility for Supplemental Security Income Payments -- MISSIC Screens Signature Proxy	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-MISSICS Screens Signature Proxy			MISSICS_Screens_8203_02-26-07 Signature Proxy.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 36,338	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	36,338	-134,662	171,000
Annual IC Time Burden (Hours)	11,507	-44,887	56,394
Annual IC Cost Burden (Dollars)	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.