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f) State Notification to SSA of Deceased Claimant
SSI Notice of Interim Assistance Reimbursement (IAR)
OMB: 0960-0546
IC ID: 186512
OMB.report
SSA
OMB 0960-0546
ICR 201107-0960-007
IC 186512
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0546 can be found here:
2020-10-06 - Revision of a currently approved collection
2017-08-04 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
f) State Notification to SSA of Deceased Claimant
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 416.1920, 416.1922
20 CFR 416.1901-416.1902, 416.1904
20 CFR 416.1906, 416.1908, 416.1910
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
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:
40
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
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
40
0
0
0
0
40
Annual IC Time Burden (Hours)
10
0
0
0
0
10
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.