Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0960-0696	ICR Reference No: 200712-0960-001
Status: Historical Active	Previous ICR Reference No: 200709-0960-001
Agency/Subagency: SSA	Agency Tracking No:
Title: Application for Help with Medicare Prescription Drug Plan Costs
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/21/2008
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/13/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2011	36 Months From Approved	02/29/2008
Responses	2,926,110	0	7,000,000
Time Burden (Hours)	1,804,435	0	4,416,667
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	2,926,110	7,000,000	-4,073,890
Annual Time Burden (Hours)	1,804,435	4,416,667	-2,612,232
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Adjusted numbers reflect the most accurate form completion data captured by SSA. Please note that the Internet SSA-1020 is not a new IC, but is reflected as such in ROCIS since this collection was originally submitted in paper form prior to the creation of ROCIS.