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) Modified 155687 77844 0 Other-Screens for SSA field office interview
Application for Help with Medicare Prescription Drug Plan Costs (Paper Form) Modified 617070 308535 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 282228 117595 0 Form and Instruction i1020 Internet Application for Extra Help with Medicare Prescription Drug Plan Costs
Total burden requested under this ICR: 1054985 503974 0  
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