APPROVED ON THE
CONDITION THAT HHS VERIFY THE BURDEN ESTIMATE OF 33 MINUTES BASED
ON ACTUAL FIELD EXPERIENCE AND REPORT BACK TO OMB WITH THE
FINDINGS.
Inventory as of this Action
Requested
Previously Approved
04/30/1983
04/30/1983
554,000
0
0
304,700
0
0
0
0
0
SECTION 1631(E) OF THE SOCIAL SECURITY
ACT PROVIDES FOR INFORMATION REQUIRED TO MAKE A DETERMINATION
REGARDING SUPPLEMENTAL SECURITY INCOM (SSI) BENEFITS. THIS FORM IS
USED TO ELICIT REQUIRED INFORMATION FROM ALL APPLICANT'S WISHING TO
BE CONSIDERED FOR SSI BENEFITS SO THAT A DETERMINATION ON
ELIGIBILITY CAN BE MADE.
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.