2024-22719. Agency Information Collection Activities: Comment Request

Modality of completion	Number of respondents	Frequency of response	Total number of respondents	Average burden per response (in minutes)	Total annual burden (hours)	Average theoretical hourly cost *	Total annual opportunity cost **
Informed consent form and release form	700	1	700	10	117	* $7.25	** $848
Baseline survey	700	1	700	15	175	* 7.25	** 1,269
12-month follow-up survey	560	1	560	20	187	* 7.25	** 1,356
Qualitative data collection with site staff	18	2	36	68	41	* 31.48	** 1,291
Qualitative data collection with treatment group members	4	3	12	45	9	* 7.25	** 65
Total	1,982		2,008		529		** 4,829
* We based this figure on the average minimum wage, as reported by Pennsylvania's Current data at Department of Labor & Industry data ( https://www.dli.pa.gov/​Individuals/​Labor-ManagementRelations/​llc/​Pages/​Wage-FAQs.aspx).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application.