Ssa-9310

Medicare Subsidy Quality Review Case Analysis

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0707 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-9310 SSA-9310 Form and Instruction
SSA-9310 Request for Documents SSA-9310-Request for Documents.doc Form and Instruction
SSA-9310.doc Current SSA-9310 IC Document

Information Collection (IC) Details

IC Title:	SSA-9310	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 418(b)(5) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-9310	Request for Documents	SSA-9310-Request for Documents.doc		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,000	-5,000	10,000
Annual IC Time Burden (Hours)	417	-416	833
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-9310	SSA-9310.doc	12/22/2008

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