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
Financial Institutions
Modified
5000
833
0
Form
SSA-4640
Authorization...
Medicare Part D Subsidy Applicants or Claimants
Modified
5000
833
0
Form
SSA-4640
Authorization for the Social Security Administration to Obtain Account Records from a Financial Institution and Request for Records (Medicare) (As completed by the claimant)
Total burden requested under this ICR:
10000
1666
0
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