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Record of SSI Inquiry
Record of Supplemental Security Income Inquiry
OMB: 0960-0140
IC ID: 9121
OMB.report
SSA
OMB 0960-0140
ICR 200808-0960-003
IC 9121
( )
Documents and Forms
Document Name
Document Type
Form SSA-3462
Record of SSI Inquiry
Form
SSA-3462 Record of Supplemental Security Income Inquiry--MSSICS S
MSSICS Screens for SSA-3462.pdf
Form
SSA-3462 Record of Supplemental Security Income Inquiry
SSA-3462.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Record of SSI Inquiry
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 416.345
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-3462
Record of Supplemental Security Income Inquiry--MSSICS Screens
MSSICS Screens for SSA-3462.pdf
Yes
Yes
Fillable Fileable Signable
Form
SSA-3462
Record of Supplemental Security Income Inquiry
SSA-3462.pdf
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:
1,800,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
98 %
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
1,800,000
0
0
-334,100
0
2,134,100
Annual IC Time Burden (Hours)
150,000
0
0
-27,842
0
177,842
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.