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OMB Control No: 0960-0782	ICR Reference No: 202509-0960-001
Status: Received in OIRA	Previous ICR Reference No: 202404-0960-004
Agency/Subagency: SSA	Agency Tracking No:
Title: Questionnaire About Special Veterans Benefits
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 01/02/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2026
Responses	27	85
Time Burden (Hours)	23	55
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	27	85	-58
Annual Time Burden (Hours)	23	55	-32
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: When we last cleared this IC in 2023, the burden was 28 hours. However, we are currently reporting a burden of 9 hours. This change stems from a decrease in the number of responses from 85 to 27. As we mentioned in #3 above, the respondents are World War II veterans aged 95+, so the respondent pool will continue to decrease over the next several years. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change. These figures represent current Management Information data. Note: The total burden reflected in ROCIS is 23, while the burden cited in #12 of the Supporting Statement is 9. This discrepancy is because the ROCIS burden reflects the learning costs.

Annual Cost to Federal Government: $3,844

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

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