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Baseline Survey Materials
Accelerated Benefits Demonstration Project
OMB: 0960-0747
IC ID: 180016
OMB.report
SSA
OMB 0960-0747
ICR 200812-0960-018
IC 180016
( )
Documents and Forms
Document Name
Document Type
Appendix C.pdf
Note: completed by interviewer
Other-Survey Script
Appendix D.doc
Other-Consent Forms
Appendix A.doc
Other-Survey Letter
Appendix B.doc
Other-Fact Sheet
0960-0747 revised documents.pdf
Revised Materials
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Baseline Survey Materials
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Survey Script
Appendix C.pdf
Note: completed by interviewer
No
Paper Only
Other-Consent Forms
Appendix D.doc
No
Paper Only
Other-Survey Letter
Appendix A.doc
No
Paper Only
Other-Fact Sheet
Appendix B.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:
37,812
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
0
0
-37,812
0
0
37,812
Annual IC Time Burden (Hours)
0
0
-6,572
0
0
6,572
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Revised Materials
0960-0747 revised documents.pdf
03/24/2008
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.