Information Collection

Notification Of Action Under Section 1122 Of The Social Security Act

IC 165964 under ICR 197706-0935-002 · OMB 0935-0003.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	NOTIFICATION OF ACTION UNDER SECTION 1122 OF THE SOCIAL SECURITY ACT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HRABHPRD022				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	10,250	10,250
Annual IC Time Burden (Hours)	5,125	5,125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.