THE INFORMATION REQUESTED ON FORM
SSA-3368 IS NEEDED IN ORDER TO MAKE A DETERMINATION FOR A
DISABILITY CLAIM. FORM SSA-3369 SUPPLEMENTS THE SSA-3368 REGARDING
ADDITIONAL INFORMATION ABOUT PAST WORK EXPERIENCE. THE INFORMATION
WILL BE USED TO FURTHER DOCUMENT A CLAIM. THESE FORMS ARE ESSENTIAL
TO CASE DEVELOPMENT AND ADJUDICATION.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.