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: 200907-0960-002
Status: Historical Active	Previous ICR Reference No: 200812-0960-010
Agency/Subagency: SSA	Agency Tracking No:
Title: Application for Help with Medicare Prescription Drug Plan Costs
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/21/2009
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/02/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2012	02/29/2012	02/29/2012
Responses	1,020,000	0	1,000,000
Time Burden (Hours)	481,333	0	480,000
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute
Annual Number of Responses	1,020,000	1,000,000	20,000
Annual Time Burden (Hours)	481,333	480,000	1,333
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: The burden is increasing slightly to account for the respondents who have erroneously submitted an old form SSA-1020 in 2010 and as a result will receive and respond to the MSP letter.