Monthly Statistical Report On Recipients And Payments Under State Administered Assistance Programs For Aged, Blind, And Disabled (individuals And Couples) Recipients

MONTHLY STATISTICAL REPORT ON RECIPIENTS AND PAYMENTS UNDER STATE ADMINISTERED ASSISTANCE PROGRAMS FOR AGED, BLIND, AND DISABLED (INDIVIDUALS AND COUPLES) RECIPIENTS

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0130 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	MONTHLY STATISTICAL REPORT ON RECIPIENTS AND PAYMENTS UNDER STATE ADMINISTERED ASSISTANCE PROGRAMS FOR AGED, BLIND, AND DISABLED (INDIVIDUALS AND COUPLES) RECIPIENTS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

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
Form	SSA-9741				No	No
Form	(1-74)				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 26	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	104	0	104
Annual IC Time Burden (Hours)	312	-104	416
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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