Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Statement of Care and Responsibility for Beneficiary - 20 CFR, 404.2020, .2025, & 416.620, .625 Migrated 130000 21667 0 Form SSA-788
Total burden requested under this ICR: 130000 21667 0  
To view an IC, click on IC Title