Medicare Part B Income-Related Premium -- Life-Changing Event

ICR 200812-0960-006

OMB: 0960-0735

Federal Form Document

ICR Details
0960-0735 200812-0960-006
Historical Active 200609-0960-030
SSA
Medicare Part B Income-Related Premium -- Life-Changing Event
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 12/29/2008
Retrieve Notice of Action (NOA) 12/10/2008
  Inventory as of this Action Requested Previously Approved
11/30/2009 11/30/2009 11/30/2009
76,100 0 76,100
79,905 0 79,905
0 0 0

This ICR is for minor, non-substantive langauge changes we plan to make to form SSA-44. Please see IC for current and new versions of the form.

PL: Pub.L. 108 - 173 811 Name of Law: Medicare Modernization Act of 2003
   US Code: 42 USC 1395r Name of Law: Social Security Act
  
PL: Pub.L. 108 - 173 811 Name of Law: Medicare Modernization Act of 2003

Not associated with rulemaking

  71 FR 43270 07/31/2006
71 FR 58041 10/02/2006
No

  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 76,100 76,100 0 0 0 0
Annual Time Burden (Hours) 79,905 79,905 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
These burden increases are due to new Medicare Part B requirements imposed by the Medicare Modernization Act of 2003.

$3,419,173
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 liz.davidson@ssa.gov

  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.
12/10/2008


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