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Protection and Advocacy for Beneficiaries of Social Security (PABSS)--Grant Awardees
Protection and Advocacy for Beneficiaries of Social Security (PABSS)
OMB: 0960-0768
IC ID: 181691
OMB.report
SSA
OMB 0960-0768
ICR 202503-0960-007
IC 181691
( )
Documents and Forms
Document Name
Document Type
Form SSA-4570
Protection and Advocacy for Beneficiaries of Social Security (PABSS)--Grant Awardees
Form
SSA-4570 Protection and Advocacy for Beneficiaries of Social Secu
SSA-4570 -Revised Version.pdf
Form
SSA-4570 -Current Version.pdf
Current SSA-4570
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Protection and Advocacy for Beneficiaries of Social Security (PABSS)--Grant Awardees
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR 435.51-435.52
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-4570
Protection and Advocacy for Beneficiaries of Social Security (PABSS) Annual Performance Report
SSA-4570 -Revised Version.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
57
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
57
0
0
0
0
57
Annual IC Time Burden (Hours)
1,368
0
0
0
0
1,368
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Current SSA-4570
SSA-4570 -Current Version.pdf
03/18/2025
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.