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Certificate of Support
Certificate of Support
OMB: 0960-0001
IC ID: 8859
OMB.report
SSA
OMB 0960-0001
ICR 202105-0960-003
IC 8859
( )
Documents and Forms
Document Name
Document Type
Form SSA-760
Certificate of Support
Form and Instruction
Revised PA & PRA Statements.pdf
Other-Revised PA & PRA Statements
SSA-760 Certificate of Support
SSA-760 - Revised.pdf
Form and Instruction
SSA-760 - Current.pdf
SSA-760 - Current
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Certificate of Support
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 404.370
20 CFR 404.750
20 CFR 404.408a
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
SSA-760
Certificate of Support
SSA-760 - Revised.pdf
Yes
No
Fillable Printable
Other-Revised PA & PRA Statements
Revised PA & PRA Statements.pdf
Yes
No
Fillable Printable
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:
18,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
18,000
0
0
0
0
18,000
Annual IC Time Burden (Hours)
4,500
0
0
0
0
4,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA-760 - Current
SSA-760 - Current.pdf
11/05/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.