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 108194 54097 0 Other-Screens for SSA field office interview
Application for Help with Medicare Prescription Drug Plan Costs (Paper Form) Unchanged 531715 265858 0 Form and Instruction SSA-1020 Application for Help with Medicare Prescription Drug Plan Costs
Other-Revised PA Statement
Internet Application for Help with Medicare Prescription Drug Plan Costs Unchanged 346642 144434 0 Form and Instruction i1020 Internet Application for Extra Help with Medicare Prescription Drug Plan Costs
Total burden requested under this ICR: 986551 464389 0  
To view an IC, click on IC Title