REPORT OF PHYSICAL CONDITION OF CLAIMANT UNDER RUIA

ICR 198006-3220-011

OMB: 3220-0035

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
176949 Migrated
ICR Details
3220-0035 198006-3220-011
Historical Active 197909-3220-008
RRB
REPORT OF PHYSICAL CONDITION OF CLAIMANT UNDER RUIA
No material or nonsubstantive change to a currently approved collection   No
Emergency 06/24/1980
Approved with change 06/24/1980
Retrieve Notice of Action (NOA) 06/24/1980
  Inventory as of this Action Requested Previously Approved
08/31/1980 08/31/1980 06/30/1980
1,500 0 1,500
125 0 125
0 0 0



None
None


No

1
IC Title Form No. Form Name
REPORT OF PHYSICAL CONDITION OF CLAIMANT UNDER RUIA SI-34

  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 1,500 1,500 0 0 0 0
Annual Time Burden (Hours) 125 125 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.
06/24/1980


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