Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Application for Extra Help With Medicare Prescription Drug Plan Costs (field office interview) New 200000 100000 0 Other-Screens for SSA field office interview
Application for Help with Medicare Prescription Drug Plan Costs (Paper Form) Modified 560000 280000 0 Form and Instruction SSA-1020 Application for Help with Medicare Prescription Drug Plan Costs
Internet Application for Help with Medicare Prescription Drug Plan Costs Modified 240000 100000 0 Form and Instruction i1020 Internet Application for Help with Medicare Prescription Drug Plan Costs
Total burden requested under this ICR: 1000000 480000 0  
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