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
Marital Relationship Questionnaire
Unchanged
1275
106
0
Other-Internal Use Screens
Marital Relationship Questionnaire (Form SSA-4178)
Modified
3825
319
0
Form
SSA-4178
Marital Relationship Questionnaire
Other-Revised PA Statement
Total burden requested under this ICR:
5100
425
0
To view an IC, click on IC Title
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