SOCIAL SECURITY DISABILITY BENEFICIARY REPORT

ICR 197803-0960-006

OMB: 0960-0115

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
114741 Migrated
ICR Details
0960-0115 197803-0960-006
Historical Active 197701-0960-010
SSA
SOCIAL SECURITY DISABILITY BENEFICIARY REPORT
Revision of a currently approved collection   No
Regular
Approved without change 03/09/1978
Retrieve Notice of Action (NOA) 03/06/1978
  Inventory as of this Action Requested Previously Approved
02/28/1983 02/28/1983 08/31/1981
200,000 0 200,000
50,000 0 50,000
0 0 0

SECTIONS 221(A) AND (B) OF THE SOCIAL SECURITY ACT PROVIDES FOR INFORMATION REGARDING THE DETERMINATION OF THE DAY A DISABILITY BENEFICIARY BEGINS TO RECEIVE PAYMENTS AND ON WHICH SUCH DISABILITY CEASES. THIS FORM IS USED TO DETERMINE WHETHER THE INDIVIDUAL CONTINUES TO BE UNABLE TO ENGAGE IN SUBSTANTIAL GAINFUL ACTIVITY BY REASON OF IMPAIRMENT AND TO OBTAIN INFORMATION CONCERNING THE INDIVIDUAL'S CONTINUING DISABILITY CONDITION

None
None


No

1
IC Title Form No. Form Name
SOCIAL SECURITY DISABILITY BENEFICIARY REPORT SSA-454A

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 200,000 200,000 0 0 0 0
Annual Time Burden (Hours) 50,000 50,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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.
03/06/1978


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