Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Statement of Care and Responsibility for Beneficiary Modified 134000 22333 0 Form SSA-788 Statement of Care and Responsibility for Beneficiary
Other-Paper Reduction Act Statement revised
Other-Privacy Act Statement (revised)
Total burden requested under this ICR: 134000 22333 0  
To view an IC, click on IC Title