Quarterly Statistical Report on Recipients and Payments Under State-Administered Assistance Programs for Aged, Blind, and Disabled Recipients

Documents and Forms

Document Name Document Type
Form SSA-9741 Quarterly Statistical Report on Recipients and Payments Under State-Administered Assistance Programs for Aged, Blind, and Disabled Recipients Form and Instruction
SSA-9741 Quarterly Statistical Report on Recipients and Payments Form SSA-9174 (0960-0130).pdf Form and Instruction
new 0960-0130 PRA statement[1].doc New PRA Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Quarterly Statistical Report on Recipients and Payments Under State-Administered Assistance Programs for Aged, Blind, and Disabled Recipients	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 416.2010 20 CFR 416.2098

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-9741	Quarterly Statistical Report on Recipients and Payments Under State Administered State Assistance Programs for Aged, Blind, and Disabled Recipients	Form SSA-9174 (0960-0130).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 31	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	124	124
Annual IC Time Burden (Hours)	124	124
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
New PRA Statement	new 0960-0130 PRA statement[1].doc	06/05/2008

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