Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Paper Form (mailed) Modified 39000 29250 0 Form and Instruction SSA-44 Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event
Personal Interview (SSA Field Office) Unchanged 147000 73500 0 Other-Intranet Screens
Total burden requested under this ICR: 186000 102750 0  
To view an IC, click on IC Title