Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Marital Relationship Questionnaire Modified 1275 106 0 Other-SSI Claims System Screen
Marital Relationship Questionnaire (Form SSA-4178) Modified 3825 319 0 Form SSA-4178 Marital Relationship Questionnaire
Other-Revised PRA Statement
Total burden requested under this ICR: 5100 425 0  
To view an IC, click on IC Title