View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0960-0395	ICR Reference No: 201311-0960-013
Status: Historical Active	Previous ICR Reference No: 201107-0960-008
Agency/Subagency: SSA	Agency Tracking No:
Title: Modified Benefit Formula 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: 06/16/2014
	Date Received in OIRA: 04/02/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	36 Months From Approved	06/30/2014
Responses	90,000	0	90,000
Time Burden (Hours)	12,000	0	12,000
Cost Burden (Dollars)	0	0	0

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