Information Collection

Application For Total Disability Income Provision (nonmedical)

IC 174325 under ICR 198011-2900-086 · OMB 2900-0126.

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR TOTAL DISABILITY INCOME PROVISION (NONMEDICAL)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	29-1606A				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	150	-250	400
Annual IC Time Burden (Hours)	50	-83	133
Annual IC Cost Burden (Dollars)	0	0	0

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