PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Application for Child's Insurance Benefits / Death Claim / Modernized Claims System (MCS)/ Signature Proxy
Unchanged
387125
90329
0
Form
SSA-4-BK (Modernized Claims System Screens)
Application for Child's Insurance Benefits
Application for Child's Insurance Benefits / Death Claim / SSA-4-BK
Unchanged
40750
10188
0
Form
SSA-4-BK
Application for Child's Insurance Benefits
Application for Child's Insurance Benefits / Death Claim/MCS
Unchanged
387125
96781
0
Form
SSA-4-BK (Modernized Claims System Screens)
Application for Child's Insurance Benefits
Application for Child's Insurance Benefits / Life Claim / MCS
Unchanged
439375
73229
0
Form
SSA-4-BK (Modernized Claims System version)
Application for Child's Insurance Benefits
Application for Child's Insurance Benefits / Life Claim / MCS / Signature Proxy
Unchanged
439375
65906
0
Form
SSA-4-BK (Modernized Claims System version)
Application for Child's Insurance Benefits
Application for Child's Insurance Benefits / Life Claim / SSA-4-BK
Unchanged
46250
7708
0
Form
SSA-4-BK
Application for Child's Insurance Benefits
Total burden requested under this ICR:
1740000
344141
0
To view an IC, click on IC Title
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