Letter to Landlord Requesting Rental Information

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0454 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-L5061 Letter to Landlord Requesting Rental Information Form and Instruction
SSI Claims System Screens.pdf Other-Internal Screens
Revised PA & PRA Statements.pdf Other-Revised PA & PRA Statements
SSA-L5061 Letter to Landlord Requesting Rental Information SSA-L5061 - Revised.pdf Form and Instruction
SSA-L5061 - Current.pdf SSA-L5061 - Current IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Letter to Landlord Requesting Rental Information	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 416.1130(b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-L5061	Letter to Landlord Requesting Rental Information	SSA-L5061 - Revised.pdf	No		Fillable Printable
Other-Internal Screens			SSI Claims System Screens.pdf	Yes	Yes	Fillable Fileable
Other-Revised PA & PRA Statements			Revised PA & PRA Statements.pdf	No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 71,280	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	71,280	-720	72,000
Annual IC Time Burden (Hours)	11,880	-120	12,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-L5061 - Current	SSA-L5061 - Current.pdf	09/08/2020

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