View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0037	ICR Reference No: 198608-0960-014
Status: Historical Active	Previous ICR Reference No: 198603-0960-007
Agency/Subagency: SSA	Agency Tracking No:
Title: REQUEST FOR WAIVER AND RECOVERY QUESTIONNAIRE
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/17/1986
	Date Received in OIRA: 08/19/1986
Terms of Clearance: This request is approved for one year with the following conditions: 1. The question, "Were you living with the overpaid person when he was overpaid?" must be deleted. 2. If HHS requests an extension next year, it must include evidence that this revised form contributed to increased recovery of overpayments, including statistics showing recovery due directly to this increased information.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/1987	11/30/1987	10/31/1986
Responses	500,000	0	500,000
Time Burden (Hours)	333,333	0	166,666
Cost Burden (Dollars)	0	0	0

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